Drivers Affidavit Ringor.docx

REPUBLIC OF THE PHILIPPINES..}. ZAMBOANGA CITY………….....} S.S. x-----------------------------------------------x DRIVER’S AFFIDAVIT I, MANOLITO AGUSTIN RINGOR, of legal age, married, Filipino and a resident of Tumaga, Zamboanga City, Philippines, after having been duly sworn to an oath in accordance with law, do hereby depose and declare: 1. That I am the authorized driver of one (1) utility vehicle and registered in the name of Ringstar Ventures Inc., described as follows: MAKE TYPE PLATE No. MOTOR No. SERIAL No.

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TOYOTA WAGON 1GD0330887 PA2CA8EM2H0029970

2. That on October 26, 2017 at around 10:00 o’clock in the morning, while I was slowly driving the said vehicle on my to Office (Ringstar Ventures Inc.) when I accidently hit the hallow block and caused scratch at the Right Front Fender of the said vehicle; 3. That I am executing this affidavit to attest to the truth of the foregoing facts and circumstances and as a requirement from the insurance company.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this _____________________ at Zamboanga City, Philippines.

MANOLITO AGUSTIN RINGOR Affiant SUBSCRIBED AND SWORN TO BEFORE ME on the above date and place.