Accident 3w651t
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REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, DANTE M. GANIR, Filipino, of legal age, married and a resident of 3 48 Nedia St., Obrero, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a holder of a valid non-professional driver’s license with no. #L04-81-002304; 2. On June 6, 2002, at around 5:00 p.m., I drove a motor vehicle ed under the name of my wife Zenaida R. Ganir, which motor vehicle is more particularly described as follows: Make Series Color Motor No. Chassis No. Plate No.
: : : : : :
TOYOTA Hilux d-cab Dark Green 3L-4427288 LN166-0001962 LDF-879
3. On said date and time, I parked the above-mentioned vehicle at the parking area of Victoria Plaza located at Bajada, Davao City; 4. When I came back after one (1) hour, I discovered that the right rear signal light assembly was already damaged/broken. I also discovered that there was a dent on the right rear portion of the said vehicle; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this June 7, 2002 in the City of Davao, Philippines.
DANTE M. GANIR Affiant SUBSCRIBED AND SWORN to before me this June 7, 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02526111 issued on April 30, 2002 at Davao City.
Doc No. Page No. Book No. Series of
180 37 VI 2002
RAYMOND B. BATU Notary Public Until December 31, 2002 IBP NO. 539876 - 12/28/01 D.C. PTR NO. 6274615 - 01/03/02 D.C.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, DEXTER ZENO ACHILLES S. PASCUA, Filipino, of legal age, single and a resident of Central Park, Bangkal, Davao City, after having been sworn to in accordance with law do hereby depose and state that: 1. I am a holder of a Professional Driver’s License with License #L02-00-141514; 2. Sometime on December 28, 2001, I was driving a motor vehicle ed under the name of my brother, Julius Aidan S. Pascua, which motor vehicle is more particularly described as follows: Make : HONDA Series : VTI SEDAN Color : Green Plate No. : UKA-850 3. While the said vehicle was parked outside my brother’s house at 35 NHA-Mamay Buhangin, Davao City, the same was maliciously scratched by an unidentified person causing damage in the form of scratch and dent that runs through the side, hood, fender and side mirrors which was probably perpetrated through the use of softdrink cap; 4. The rear portion of the vehicle has likewise sustained stone marks and kick marks; 5. The said vehicle is covered by Mapfre Asian Insurance Corporation under Policy No. 8990483; 6. I have no knowledge of facts indicating who was responsible for the said damages; 7. I attest to the truthfulness of the above facts and I am
executing this affidavit for whatever purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this February 20, 2002 in the City of Davao, Philippines. DEXTER ZENO ACHILLES S. PASCUA Affiant SUBSCRIBED AND SWORN to before me this 20 th day of February 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate with No. 16776270 issued on February 20, 2002 at Davao City, Philippines. Doc. No. 108; Page No. 23; Book No. II; Series of 2002.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ALBERTO T. LIM, Filipino, of legal age, married and a resident of Tomas Monteverde Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am the ed owner of a motor vehicle, which is particularly described as follows: Make Series Color Motor No. Chassis No. Plate No.
: : : : :
TOYOTA REVO Amazon Green 2L-9706329 : LF80-8007938 LEK-130
2. On December 9, 2001 at around 6:00 o’clock in the evening, I drove/operated my car and went to APUNG KULA – IHAW IHAW along Quimpo Boulevard, Davao City. I parked my car at the parking space of APUNG KULA; 3. When I came back after two (2) hours, I discovered that there were already visible scratches on both sides of my car (left and Right portion); 4. Street children roaming around Quimpo Boulevard, Davao City could have done the scratches on my car, which I presume to have been made by the use of a coin; 5. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this January 8, 2002 in the City of Davao, Philippines.
ALBERTO T. LIM Affiant SUBSCRIBED AND SWORN to before me this January 8, 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 01020124 issued on January 9, 2001 at Davao City. Doc. No. Page No. Book No. Series of
2 2 VI 2002
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ENERIE B. AQUINO, Filipino, of legal age, widow and a resident of # 158-A J.P. Cabaguio Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a the ed owner of a motor vehicle which is particularly described as follows: Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
HONDA Sedan Cyclone Blue PH16A-0009358 PHS04-4A3382 LCY 908
2. On November 19, 2001, while my driver, Mr. Roberto Concoles, was cleaning the above-described vehicle at my house located at Cabaguio Avenue, Davao City, he accidentally placed my Aerosol car spray perfume (can type) at the back portion of my vehicle; 3. On the same day at around 1:00 p.m., I used my car and went to Victoria Plaza, Bajada, Davao City. I parked my car at the parking space of Victoria Plaza; 4. When I came back after two (2) hours, I discovered that the right portion of my back dashboard was already damaged and had a big crack. I further discovered that the Aerosol car spray perfume (can type) had exploded due probably to the intense heat of the sun; 5. The damage of my back dashboard was due to the explosion of the Aerosol car spray perfume (can type); 6 I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this November 21, 2001 in the City of Davao, Philippines. ENERIE B. AQUINO Affiant SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 18966966 issued on January 17, 2001 at Davao City. Doc. No. Page No. Book No.
Series of D.C.
102 22 V
2001
RAYMOND B. BATU NOTARY PUBLIC IBP NO. 14570 – 12/29/2000 – D.C.
PTR NO. 5198149 – 01/02/2001 –
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ENERIE B. AQUINO, Filipino, of legal age, widow and a resident of # 158-A J.P. Cabaguio Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a the ed owner of a motor vehicle which is particularly described as follows: Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
HONDA Sedan Cyclone Blue PH16A-0009358 PHS04-4A3382 LCY 908
2. On November 15, 2001, while I was driving the above-described vehicle at the Buhangin Diversion Road going to Toril, Davao City, a Cargo Truck proceeding opposite to my direction accidentally hit a stone; 3. Unfortunately, the stone flew and directly hit the right side of the windshield (enger side) of the vehicle I was driving which caused a crack and damage to the said windshield; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this November 21, 2001 in the City of Davao, Philippines.
ENERIE B. AQUINO Affiant SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 18966966 issued on January 17, 2001 at Davao City.
Doc. No. Page No. Book No.
Series of D.C.
102 22 V
2001
RAYMOND B. BATU NOTARY PUBLIC IBP NO. 14570 – 12/29/2000 – D.C.
PTR NO. 5198149 – 01/02/2001 –
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, ROGELIO R. AMORADO, Filipino, of legal age, married and a resident of Flores Village, Bangkal, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On September 9, 2000, at around Eight O’clock in the morning, while I was backing-up and maneuvering our vehicle inside the parking space of our house, I did not notice a cemented wall at the front portion; 2. That I accidentally hit the cemented wall which caused damage to the RIGHT HAND FENDER, HOOD, RIGHT HAND BUMPER and RIGHT HAND SIGNAL LIGHT of the vehicle; 3. The said vehicle, which is ed under the name of my wife Anita V. Amorado, is particularly described as follows : Make & Type Motor No. : Chasis No. : Plate No. : Color :
:
Mitsubishi Lancer EL 4GI3A-CO253 CB1ASN-16708 LCY 620 Spruce Green
4. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of Davao, Philippines.
ROGELIO R. AMORADO Affiant SUBSCRIBED AND SWORN to before me this September 9, 2000 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 00790662 issued on March 9, 2000 at Davao City. Doc. No. 370 Page No. 75 Book No. II Series of 2000. Davao City
RAYMOND B. BATU Notary Public Until December 31, 2000 IBP NO. 492785 – 12/29/1999 –
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, GIOVANNI S. GALON, Filipino, of legal age, single and a resident of 26-b Santos Subdivision, Bangkal, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On June 21, 2000, at around One Thirty o’clock in the morning, I was driving a Tamaraw FX along Anda St. and heading towards the intersection of Rizal and Anda St., Davao City. The said vehicle is particularly described, as follows : Motor No. : 2C-31477697 Chasis No. : CF50-0023363 Plate No. : LDB- 725 2. The above-described vehicle is ed under the name of my father, Franito R. Galon; 3. While still in the portion of Anda St. (In front of Clappers KTV Bar and Restaurant), I decided to make a U-TURN so that I can go back to Bonifacio St., Davao City; 4. When I made a U-TURN, my calculation was rather short since there was a parked vehicle in front of Clappers KTV and Restaurant. That because of such, I backed-up the vehicle I was driving; 5. I did not notice that there was a Davao Light Power and Company Electric Posts at the back, which I accidentally hit; 6. The rear portion of the vehicle, particularly the rear door, suffered minor damage; 7. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of Davao, Philippines.
GIOVANNI S. GALON. Affiant SUBSCRIBED AND SWORN to before me this June 22, 2000 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 00919932 issued on June 22, 2000 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, JASON BANGAYAN, Filipino, of legal age, single and a resident of Bo. Obrero, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On July 14, 1997, at around three o’clock in the afternoon, I parked a white Toyota Corolla GL Sedan in front of the McDonald’s outlet near Victoria Plaza, Bajada, Davao City. The said vehicle is particularly described, as follows : Motor No. : 4A-769122 Chasis No. : AE92-013693 Plate No. : PLT-602 2. The above-described vehicle is ed under the name of my father, Dr. Teofilo Bangayan; 3. After parking the car at the place stated above, I went inside the Victoria Plaza mall to check on my business; 4. When I returned to the car at around 5:30 P. M., I noticed that there was a dent on the left rear corner of the car and a deformation on its rear bumper; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of Davao, Philippines.
JASON BANGAYAN Affiant SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 7932145E issued on May 23, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, LEOPOLDO R. TORREON, Filipino, of legal age, married and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I am an employee of the City Government of Davao having been assigned as driver of a Hino Garbage Truck bearing plate number CEN 189 owned by the City Government of Davao; 2. On April 14, 1998 at about 11:30 P.M., I was driving the abovedescribed vehicle and seated with me was a fellow City Government employee; 3. While we were cruising along the Ma-a Diversion Road going towards the City Dumpsite, I noticed that that the truck I was driving was on fire; 4. I immediately parked the said truck while my companion communicated through a VHF radio our main office for assistance; 5. After parking the said truck, I jumped out and poured sand on the fire until a few minutes later, CENRO personnel helped me in putting out the fire; 6. After due investigation, it was found out that the terminal cable and other wirings of said truck were grounded which caused an ignition and set the truck on fire; I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. In witness whereof, I hereunto affix my signature this 25th day of April, 1998 in the City of Davao, Philippines.
LEOPOLDO R. TORREON Affiant SUBSCRIBED AND SWORN to before me this 25th day of April, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02609851 issued on March 17, 1998 at Davao City.
Doc. No. ___; Page No. ___; Book No. VI Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, THELMA SIMPAO REYES, Filipino, of legal age, single (by annulment) and a resident of Doña Vicenta, Bajada, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I am the holder of a Professional Driver’s License with License No. L02-66-001221 issued by the Land Transportation Office (LTO), which will expire in 1998; 2. I am also the ed owner of a private car which is particularly described, as follows : Make : Toyota Series : Corolla Type of Body : Sedan Motor No. : 2E-2410859 Serial/Chassis No. : EE90-9069582 3. On July 19, 1997 at about 11:30 P.M., I parked the above-described in the premises of Shrine Hill, Matina, Davao City; 4. When I returned, and was about to board said vehicle, I noticed that the front left side portion of the bumper and the front left parklight of said vehicle were damaged. I have no knowledge as to who caused the damage; 5. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of Davao, Philippines.
THELMA SIMPAO REYES Affiant SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of Davao, Philippines, affiant exhibiting to me her Community Tax Certificate No. 265983D issued on January 16, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; City Series of 1997. M.M.
MARIE JOSEPHINE B. de VERA Notary Public PTR No. 35867222 05/09/97 IBP
No. 441336
Davao
05/02/97
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, RICKY GUTIERREZ QUILO, Filipino, of legal age, married and a resident of New Matina Gravahan, Riverside, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a holder of a valid professional license of the Land Transportation Office with license no. LO2-90-067905 and with official receipt no. 86959135. The said license is yet to expire on February 20, 1999; 2. I am a driver of the delos Santos family and is assigned to drive a vehicle ed under the name of Atty. Leo G. delos Santos of 71 Cordillera St., Central Park Subdivision, Bangkal, Davao City. The aforementioned vehicle is particularly described, as follows : Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
ISUZU FUEGO Pick-up White 580600 PABTFS55HDX200257 LDM-581
3. On February 7, 1999 at about 10: 30 A.M., while I was driving the abovedescribed vehicle along the highway going to Sta. Cruz, Davao del Sur, a YELLOW BUS proceeding opposite to my direction accidentally hit a stone; 4. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver Side) of the vehicle I was driving which caused a crack and damage to the said windshield; 5. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF , I have hereunto affixed my signature this 9th day of February, 1999 in the City of Davao, Philippines.
RICKY GUTIERREZ QUILO Affiant SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 16025098 issued on February 9, 1999 at Davao City.
Doc. No. 89; Page No. 18; Book No. IX; Series of 1999.
MARIE JOSEPHINE B. DE VERA Notary Public PTR No. 3949149 01/05/99 Davao City IBP No. 464505 12/29/98 Davao City
REPUBLIC OF THE PHILIPPINES ) CITY OF C O T A B A T O ) S.S. x--------------------------------------------------x AFFIDAVIT I, DANILO ANDRADA, Filipino, of legal age, married and a resident of Cotabato City, after having been sworn to in accordance with law hereby depose and state that: 1. I am the driver of a private vehicle which is ed under the name of TOMAS C. BUENVIAJE also a resident of Cotabato City. The aforementioned vehicle is particularly described, as follows : Make : Honda Engine No. : PH132-0001833 Serial/Chasis No. : PHSX8-2A1307 Color : Blue Type of Body : Sedan 2. On July 25, 1997 at about 1:30 P.M., I parked the above-described vehicle in the parking lot of Victoria Plaza located in Bajada, Davao City; 3. When I went back, and was about to board said vehicle, I noticed that portions of the QUARTER , TAIL LIGHT and FRONT DOOR all located at the left side of said vehicle were damaged. I have no knowledge of facts indicating how the damage was done nor of the person(s) who caused such acts; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any other legal purpose as it may serve. SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the City of Cotabato, Philippines. _______________________ DANILO ANDRADA Affiant SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the City of Cotabato, Philippines, affiant exhibiting to me his Community Tax Certificate No. 7113322 issued on March 23, 1997 at Cotabato City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, REYNALDO P. MARCELO, Filipino, of legal age, and a resident of 24-A San Antonio Village, Matina, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I was married to the late CORAZON G. MARCELO on May 31, 1965 and that this marriage was blessed with four (4) children, namely, ROBERTO, MA. LOURDES, MA. ISABEL, and REYNALDO, JR.; 2. On August 03, 1997, my wife, Corazon died in Manila due to natural course/illness; 3. Since January, 1990, my eldest son, Roberto G. Marcelo has been the breadwinner and the one ing the needs of our family; 4. As such, I have executed a Special Power of Attorney (SPA) giving him rights to be my attorney-in-fact to represent me in all transactions, to sign in my behalf, and/or collect any claims and benefits due us in relation to the demise of my wife, Corazon; 5. I attest to the truthfulness of the above facts and I am executing this affidavit and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the City of Davao, Philippines.
______________________________ REYNALDO P. MARCELO Affiant SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8010778 issued on September 25, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; City Series of 1997.
MARIE JOSEPHINE B. de VERA Notary Public PTR No. 35867222 05/09/97 IBP No. 441336
Davao
05/02/97 M.M.
AFFIDAVIT I, Zacarias S. Ortiz, Filipino, of legal age, married and a resident of Sto. Tomas, Davao del Norte, after having been sworn to in accordance with law hereby depose and state that: 1. I am the driver of a government vehicle which is ed under the name of the Municipal Government of Sto. Tomas, Davao del Norte. The aforementioned vehicle is particularly described, as follows : Make : KIA Motor No. : HW-168571 Serial/Chasis No. : KNFTB152V-6347413 Color : White Type of Body : AMBULANCE Plate Number: SEN-903 2. On March 19, 1998 at about 11:45 A.M., I was driving the aforesaid government vehicle along the National Road coming from Davao City towards Davao del Norte; 3. Upon reaching at Km. Post No.1484 (Barangay Lasang, Davao City) and DLPC Post No. 43180-3335 , I slowed down to avoid hitting another vehicle ahead of the AMBULANCE I was driving when the vehicle following me failed to apply its brake causing such vehicle to bump the rear portion of the said AMBULANCE, and as a consequence thereof, caused an undetermined value of damage of the whole rear portion of such AMBULANCE; 4. The vehicle which bumped the rear portion of the AMBULANCE I was driving was a Nissan Pick-up Double Cab with Plate Number SCH 483, color green, ed under the name of National Irrigation istration (NIA) of Sto. Nino, Carmen, Davao del Norte with CR# 004290 and MVRR # 58963994 and was driven by Fernando Patenio Y Reyes, a resident of Asuncion, Davao del Norte; 5. I attest to the truthfulness of the above facts and I am executing this affidavit for any other legal purpose as it may serve. SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of Davao, Philippines. ZACARIAS S. ORTIZ Affiant SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 2911516 issued on January 14, 1998 at Sto. Tomas, Davao del Norte.
REPUBLIC OF THE PHILIPPINES) ) SS X - - - - - - - -- - - - - - -- - - - - - - -- - --X
T AFFIDAVIT We, NAPOLEON LUMANOG and FLORENTINO MORANTE of legal ages, Filipino, married, and residents of Santo Tomas, Davao del Norte , after having been sworn to in accordance with law, hereby depose and state: 1. That we both personally know the late MODESTO V. DEMABILDO, he being our long-time friend; 2. That we know for a fact that he died on October 14, 1940 at San Carlos City, Negros Occidental; 3. That his death was not recorded in the Civil Registry; 4. That we are not related to him by consanguinity nor affinity and we are executing this affidavit for whatever legal purpose this may serve. IN WITNESS WHEREOF, we have hereunto affix our signature this 21st day of April, 1998 in ________________, Philippines.
NAPOLEON LUMANOG Affiant
FLORENTINO MORANTE Affiant
Subscribed and sworn to before me this ___ day of April, 1998 at ____________, Philippines.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, REYNALDO SAN JUAN OBRA, Filipino, of legal age, married and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that:
1. I am a Medical Representative of GLAXO PHILS. INC. and I was provided by such company with a vehicle which is ed under the name of GLAXO PHILS. INC. The aforementioned vehicle is particularly described, as follows : Make : Mitsubishi L-300 Series : Lancer Motor No.: 4G13A-A7907 Chassis No. : Cb1ASN-04592 Color : Silver Plate No. : TNG-143 2. On June 22, 1998 at about 10:30 a.m., while I was driving the above-described vehicle along the National Road in Buhangin, Davao City, a ten-wheeler truck proceeding opposite to my direction accidently hit a stone; 3. Unfortunately, the stone directly hit the front windshield of the vehicle I was driving causing damage to said windshield; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. SUBSCRIBED AND SWORN to before me this 26th day of June, 1998 in the City of Davao, Philippines.
REYNALDO SAN JUAN OBRA Affiant
REPUBLIC OF THE PHILIPPINES ) C I T Y O F D A V A O )SS x--------------------------------------------------x
I, LUZ B. PANAGUITON, of legal age, Filipino, single and a resident of Poblacion, Norala, South Cotabato, after having been sworn to in accordance with law, depose and say:
1. That I am a government employee assigned at the Department Education Culture and Sports-Norala, South Cotabato; 2. That I am a member of the Government Service Insurance System (GSIS) and my beneficiary is my mother, Mrs. Margarita Panaguiton; 3. That my 61 year-old mother, Mrs. Margarita Panaguiton, is presently confined at Limso Medical Center due to illness and there is a necessity to avail of the Medicare benefits provided for by law; 4. That I am executing this affidavit in order to attest to truth of the foregoing facts and to apprise the authorities thereof. IN WITNESS WHEREOF, I have hereunto affixed my signature this 15th day of February, 1999 at Davao City, Philippines.
LUZ B. PANAGUITON Affiant SUBSCRIBED AND SWORN to before me this 15th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me her Community Tax Certificate No. 06629947 issued on February 01, 199 at Norala, South Cotabato. Doc.No.113; Page No. 23; Book No. IX; Series of 1999.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, ARMAND C. ALBARRACIN, Filipino, of legal age, single and a resident of GSIS Heights, Matina, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. That I am an owner of a vehicle which is particularly described, as follows : Motor No. : 4G33-3AR8572 Chasis No. : A173AJL-2920 Plate No. : LAK 394 Series : Lancer Type of Body : Sedan Color : Blue 2. The above-described vehicle is ed in my name. 3. I intend to change its color from Blue to Gray. 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of Davao, Philippines.
ARMAND ALBARRACIN Affiant SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8060625 issued on January 19, 1998 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, CARNELL T. TAN, Filipino, of legal age, single and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On July 29, 1998, at around Ten o’clock in the morning, I parked a Milano white Mitsubishi Pajero along Villa Abrille Street, Davao City. The said vehicle is particularly described as follows : Make : Mitsubishi Series : Pajero Motor No. : 4D56A-H4071 Chasis No. : PAEV44WGNVBOO4927 Plate No. : LDK 258 2. The above-described vehicle is ed under the name of my mother, Mrs. Lolita Tan; 3. After parking the car at the place stated above, I went to a nearby store to purchase car accessories; 4. When I returned to the car, I noticed that there was a crack/dent on the center front corner of the car and a deformation of the same; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of Davao, Philippines.
CARNELL T. TAN Affiant SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 9738145E issued on May 23, 1998 at Davao City.
Doc. No. _____; Page No. _____; Book No. 1; Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ATTY. LEO G. DELOS SANTOS, Filipino, of legal age, married and a resident of No. 071 Cordillera St., Central Park Subdivision, Bangkal, Davao City, after having been sworn to in accordance with the law do hereby depose and states that: 1. I am the ed owner of a ISUZU Fuego Pick-up with Motor Vehicle Registry Receipt No. 08421827 and with Registration Certificate No. CR-41872263. The said vehicle is particularly described as follows : Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
ISUZU FUEGO Pick-up White 580600 PABTFS55HDX200257 LDM-581
3. On February 7, 1999 at about 10:30 A.M., my driver, RICKY GUTIERREZ QUILO and I, were on board the above-described vehicle proceeding to Malita, Davao del Sur; 4. While we were along the highway going to Sta. Cruz, Davao del Sur, a YELLOW BUS proceeding opposite to our direction accidentally hit a stone; 5. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver Side) of my vehicle which caused a crack and damage to the said windshield; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other legal purposes it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th day of February, 1999 in the City of Davao, Philippines.
ATTY. LEO G. DELOS SANTOS Affiant SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02720401 issued on January 4, 1999 at Davao City.
Doc. No. 91; Page No. 18; Book No. IX; Series of 1999.
MARIE JOSEPHINE B. DE VERA Notary Public PTR No. 3949149 01/05/99 Davao City IBP No. 464505 12/29/98 Davao City
: : : : : :
TOYOTA Hilux d-cab Dark Green 3L-4427288 LN166-0001962 LDF-879
3. On said date and time, I parked the above-mentioned vehicle at the parking area of Victoria Plaza located at Bajada, Davao City; 4. When I came back after one (1) hour, I discovered that the right rear signal light assembly was already damaged/broken. I also discovered that there was a dent on the right rear portion of the said vehicle; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this June 7, 2002 in the City of Davao, Philippines.
DANTE M. GANIR Affiant SUBSCRIBED AND SWORN to before me this June 7, 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02526111 issued on April 30, 2002 at Davao City.
Doc No. Page No. Book No. Series of
180 37 VI 2002
RAYMOND B. BATU Notary Public Until December 31, 2002 IBP NO. 539876 - 12/28/01 D.C. PTR NO. 6274615 - 01/03/02 D.C.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, DEXTER ZENO ACHILLES S. PASCUA, Filipino, of legal age, single and a resident of Central Park, Bangkal, Davao City, after having been sworn to in accordance with law do hereby depose and state that: 1. I am a holder of a Professional Driver’s License with License #L02-00-141514; 2. Sometime on December 28, 2001, I was driving a motor vehicle ed under the name of my brother, Julius Aidan S. Pascua, which motor vehicle is more particularly described as follows: Make : HONDA Series : VTI SEDAN Color : Green Plate No. : UKA-850 3. While the said vehicle was parked outside my brother’s house at 35 NHA-Mamay Buhangin, Davao City, the same was maliciously scratched by an unidentified person causing damage in the form of scratch and dent that runs through the side, hood, fender and side mirrors which was probably perpetrated through the use of softdrink cap; 4. The rear portion of the vehicle has likewise sustained stone marks and kick marks; 5. The said vehicle is covered by Mapfre Asian Insurance Corporation under Policy No. 8990483; 6. I have no knowledge of facts indicating who was responsible for the said damages; 7. I attest to the truthfulness of the above facts and I am
executing this affidavit for whatever purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this February 20, 2002 in the City of Davao, Philippines. DEXTER ZENO ACHILLES S. PASCUA Affiant SUBSCRIBED AND SWORN to before me this 20 th day of February 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate with No. 16776270 issued on February 20, 2002 at Davao City, Philippines. Doc. No. 108; Page No. 23; Book No. II; Series of 2002.
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ALBERTO T. LIM, Filipino, of legal age, married and a resident of Tomas Monteverde Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am the ed owner of a motor vehicle, which is particularly described as follows: Make Series Color Motor No. Chassis No. Plate No.
: : : : :
TOYOTA REVO Amazon Green 2L-9706329 : LF80-8007938 LEK-130
2. On December 9, 2001 at around 6:00 o’clock in the evening, I drove/operated my car and went to APUNG KULA – IHAW IHAW along Quimpo Boulevard, Davao City. I parked my car at the parking space of APUNG KULA; 3. When I came back after two (2) hours, I discovered that there were already visible scratches on both sides of my car (left and Right portion); 4. Street children roaming around Quimpo Boulevard, Davao City could have done the scratches on my car, which I presume to have been made by the use of a coin; 5. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this January 8, 2002 in the City of Davao, Philippines.
ALBERTO T. LIM Affiant SUBSCRIBED AND SWORN to before me this January 8, 2002 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 01020124 issued on January 9, 2001 at Davao City. Doc. No. Page No. Book No. Series of
2 2 VI 2002
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ENERIE B. AQUINO, Filipino, of legal age, widow and a resident of # 158-A J.P. Cabaguio Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a the ed owner of a motor vehicle which is particularly described as follows: Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
HONDA Sedan Cyclone Blue PH16A-0009358 PHS04-4A3382 LCY 908
2. On November 19, 2001, while my driver, Mr. Roberto Concoles, was cleaning the above-described vehicle at my house located at Cabaguio Avenue, Davao City, he accidentally placed my Aerosol car spray perfume (can type) at the back portion of my vehicle; 3. On the same day at around 1:00 p.m., I used my car and went to Victoria Plaza, Bajada, Davao City. I parked my car at the parking space of Victoria Plaza; 4. When I came back after two (2) hours, I discovered that the right portion of my back dashboard was already damaged and had a big crack. I further discovered that the Aerosol car spray perfume (can type) had exploded due probably to the intense heat of the sun; 5. The damage of my back dashboard was due to the explosion of the Aerosol car spray perfume (can type); 6 I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this November 21, 2001 in the City of Davao, Philippines. ENERIE B. AQUINO Affiant SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 18966966 issued on January 17, 2001 at Davao City. Doc. No. Page No. Book No.
Series of D.C.
102 22 V
2001
RAYMOND B. BATU NOTARY PUBLIC IBP NO. 14570 – 12/29/2000 – D.C.
PTR NO. 5198149 – 01/02/2001 –
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ENERIE B. AQUINO, Filipino, of legal age, widow and a resident of # 158-A J.P. Cabaguio Avenue, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a the ed owner of a motor vehicle which is particularly described as follows: Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
HONDA Sedan Cyclone Blue PH16A-0009358 PHS04-4A3382 LCY 908
2. On November 15, 2001, while I was driving the above-described vehicle at the Buhangin Diversion Road going to Toril, Davao City, a Cargo Truck proceeding opposite to my direction accidentally hit a stone; 3. Unfortunately, the stone flew and directly hit the right side of the windshield (enger side) of the vehicle I was driving which caused a crack and damage to the said windshield; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this November 21, 2001 in the City of Davao, Philippines.
ENERIE B. AQUINO Affiant SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 18966966 issued on January 17, 2001 at Davao City.
Doc. No. Page No. Book No.
Series of D.C.
102 22 V
2001
RAYMOND B. BATU NOTARY PUBLIC IBP NO. 14570 – 12/29/2000 – D.C.
PTR NO. 5198149 – 01/02/2001 –
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, ROGELIO R. AMORADO, Filipino, of legal age, married and a resident of Flores Village, Bangkal, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On September 9, 2000, at around Eight O’clock in the morning, while I was backing-up and maneuvering our vehicle inside the parking space of our house, I did not notice a cemented wall at the front portion; 2. That I accidentally hit the cemented wall which caused damage to the RIGHT HAND FENDER, HOOD, RIGHT HAND BUMPER and RIGHT HAND SIGNAL LIGHT of the vehicle; 3. The said vehicle, which is ed under the name of my wife Anita V. Amorado, is particularly described as follows : Make & Type Motor No. : Chasis No. : Plate No. : Color :
:
Mitsubishi Lancer EL 4GI3A-CO253 CB1ASN-16708 LCY 620 Spruce Green
4. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of Davao, Philippines.
ROGELIO R. AMORADO Affiant SUBSCRIBED AND SWORN to before me this September 9, 2000 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 00790662 issued on March 9, 2000 at Davao City. Doc. No. 370 Page No. 75 Book No. II Series of 2000. Davao City
RAYMOND B. BATU Notary Public Until December 31, 2000 IBP NO. 492785 – 12/29/1999 –
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, GIOVANNI S. GALON, Filipino, of legal age, single and a resident of 26-b Santos Subdivision, Bangkal, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On June 21, 2000, at around One Thirty o’clock in the morning, I was driving a Tamaraw FX along Anda St. and heading towards the intersection of Rizal and Anda St., Davao City. The said vehicle is particularly described, as follows : Motor No. : 2C-31477697 Chasis No. : CF50-0023363 Plate No. : LDB- 725 2. The above-described vehicle is ed under the name of my father, Franito R. Galon; 3. While still in the portion of Anda St. (In front of Clappers KTV Bar and Restaurant), I decided to make a U-TURN so that I can go back to Bonifacio St., Davao City; 4. When I made a U-TURN, my calculation was rather short since there was a parked vehicle in front of Clappers KTV and Restaurant. That because of such, I backed-up the vehicle I was driving; 5. I did not notice that there was a Davao Light Power and Company Electric Posts at the back, which I accidentally hit; 6. The rear portion of the vehicle, particularly the rear door, suffered minor damage; 7. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of Davao, Philippines.
GIOVANNI S. GALON. Affiant SUBSCRIBED AND SWORN to before me this June 22, 2000 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 00919932 issued on June 22, 2000 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, JASON BANGAYAN, Filipino, of legal age, single and a resident of Bo. Obrero, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On July 14, 1997, at around three o’clock in the afternoon, I parked a white Toyota Corolla GL Sedan in front of the McDonald’s outlet near Victoria Plaza, Bajada, Davao City. The said vehicle is particularly described, as follows : Motor No. : 4A-769122 Chasis No. : AE92-013693 Plate No. : PLT-602 2. The above-described vehicle is ed under the name of my father, Dr. Teofilo Bangayan; 3. After parking the car at the place stated above, I went inside the Victoria Plaza mall to check on my business; 4. When I returned to the car at around 5:30 P. M., I noticed that there was a dent on the left rear corner of the car and a deformation on its rear bumper; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of Davao, Philippines.
JASON BANGAYAN Affiant SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 7932145E issued on May 23, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, LEOPOLDO R. TORREON, Filipino, of legal age, married and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I am an employee of the City Government of Davao having been assigned as driver of a Hino Garbage Truck bearing plate number CEN 189 owned by the City Government of Davao; 2. On April 14, 1998 at about 11:30 P.M., I was driving the abovedescribed vehicle and seated with me was a fellow City Government employee; 3. While we were cruising along the Ma-a Diversion Road going towards the City Dumpsite, I noticed that that the truck I was driving was on fire; 4. I immediately parked the said truck while my companion communicated through a VHF radio our main office for assistance; 5. After parking the said truck, I jumped out and poured sand on the fire until a few minutes later, CENRO personnel helped me in putting out the fire; 6. After due investigation, it was found out that the terminal cable and other wirings of said truck were grounded which caused an ignition and set the truck on fire; I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. In witness whereof, I hereunto affix my signature this 25th day of April, 1998 in the City of Davao, Philippines.
LEOPOLDO R. TORREON Affiant SUBSCRIBED AND SWORN to before me this 25th day of April, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02609851 issued on March 17, 1998 at Davao City.
Doc. No. ___; Page No. ___; Book No. VI Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, THELMA SIMPAO REYES, Filipino, of legal age, single (by annulment) and a resident of Doña Vicenta, Bajada, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I am the holder of a Professional Driver’s License with License No. L02-66-001221 issued by the Land Transportation Office (LTO), which will expire in 1998; 2. I am also the ed owner of a private car which is particularly described, as follows : Make : Toyota Series : Corolla Type of Body : Sedan Motor No. : 2E-2410859 Serial/Chassis No. : EE90-9069582 3. On July 19, 1997 at about 11:30 P.M., I parked the above-described in the premises of Shrine Hill, Matina, Davao City; 4. When I returned, and was about to board said vehicle, I noticed that the front left side portion of the bumper and the front left parklight of said vehicle were damaged. I have no knowledge as to who caused the damage; 5. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of Davao, Philippines.
THELMA SIMPAO REYES Affiant SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of Davao, Philippines, affiant exhibiting to me her Community Tax Certificate No. 265983D issued on January 16, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; City Series of 1997. M.M.
MARIE JOSEPHINE B. de VERA Notary Public PTR No. 35867222 05/09/97 IBP
No. 441336
Davao
05/02/97
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, RICKY GUTIERREZ QUILO, Filipino, of legal age, married and a resident of New Matina Gravahan, Riverside, Davao City, after having been sworn to in accordance with law do hereby depose and states that: 1. I am a holder of a valid professional license of the Land Transportation Office with license no. LO2-90-067905 and with official receipt no. 86959135. The said license is yet to expire on February 20, 1999; 2. I am a driver of the delos Santos family and is assigned to drive a vehicle ed under the name of Atty. Leo G. delos Santos of 71 Cordillera St., Central Park Subdivision, Bangkal, Davao City. The aforementioned vehicle is particularly described, as follows : Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
ISUZU FUEGO Pick-up White 580600 PABTFS55HDX200257 LDM-581
3. On February 7, 1999 at about 10: 30 A.M., while I was driving the abovedescribed vehicle along the highway going to Sta. Cruz, Davao del Sur, a YELLOW BUS proceeding opposite to my direction accidentally hit a stone; 4. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver Side) of the vehicle I was driving which caused a crack and damage to the said windshield; 5. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. IN WITNESS WHEREOF , I have hereunto affixed my signature this 9th day of February, 1999 in the City of Davao, Philippines.
RICKY GUTIERREZ QUILO Affiant SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 16025098 issued on February 9, 1999 at Davao City.
Doc. No. 89; Page No. 18; Book No. IX; Series of 1999.
MARIE JOSEPHINE B. DE VERA Notary Public PTR No. 3949149 01/05/99 Davao City IBP No. 464505 12/29/98 Davao City
REPUBLIC OF THE PHILIPPINES ) CITY OF C O T A B A T O ) S.S. x--------------------------------------------------x AFFIDAVIT I, DANILO ANDRADA, Filipino, of legal age, married and a resident of Cotabato City, after having been sworn to in accordance with law hereby depose and state that: 1. I am the driver of a private vehicle which is ed under the name of TOMAS C. BUENVIAJE also a resident of Cotabato City. The aforementioned vehicle is particularly described, as follows : Make : Honda Engine No. : PH132-0001833 Serial/Chasis No. : PHSX8-2A1307 Color : Blue Type of Body : Sedan 2. On July 25, 1997 at about 1:30 P.M., I parked the above-described vehicle in the parking lot of Victoria Plaza located in Bajada, Davao City; 3. When I went back, and was about to board said vehicle, I noticed that portions of the QUARTER , TAIL LIGHT and FRONT DOOR all located at the left side of said vehicle were damaged. I have no knowledge of facts indicating how the damage was done nor of the person(s) who caused such acts; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any other legal purpose as it may serve. SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the City of Cotabato, Philippines. _______________________ DANILO ANDRADA Affiant SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the City of Cotabato, Philippines, affiant exhibiting to me his Community Tax Certificate No. 7113322 issued on March 23, 1997 at Cotabato City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1997.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, REYNALDO P. MARCELO, Filipino, of legal age, and a resident of 24-A San Antonio Village, Matina, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. I was married to the late CORAZON G. MARCELO on May 31, 1965 and that this marriage was blessed with four (4) children, namely, ROBERTO, MA. LOURDES, MA. ISABEL, and REYNALDO, JR.; 2. On August 03, 1997, my wife, Corazon died in Manila due to natural course/illness; 3. Since January, 1990, my eldest son, Roberto G. Marcelo has been the breadwinner and the one ing the needs of our family; 4. As such, I have executed a Special Power of Attorney (SPA) giving him rights to be my attorney-in-fact to represent me in all transactions, to sign in my behalf, and/or collect any claims and benefits due us in relation to the demise of my wife, Corazon; 5. I attest to the truthfulness of the above facts and I am executing this affidavit and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the City of Davao, Philippines.
______________________________ REYNALDO P. MARCELO Affiant SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8010778 issued on September 25, 1997 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; City Series of 1997.
MARIE JOSEPHINE B. de VERA Notary Public PTR No. 35867222 05/09/97 IBP No. 441336
Davao
05/02/97 M.M.
AFFIDAVIT I, Zacarias S. Ortiz, Filipino, of legal age, married and a resident of Sto. Tomas, Davao del Norte, after having been sworn to in accordance with law hereby depose and state that: 1. I am the driver of a government vehicle which is ed under the name of the Municipal Government of Sto. Tomas, Davao del Norte. The aforementioned vehicle is particularly described, as follows : Make : KIA Motor No. : HW-168571 Serial/Chasis No. : KNFTB152V-6347413 Color : White Type of Body : AMBULANCE Plate Number: SEN-903 2. On March 19, 1998 at about 11:45 A.M., I was driving the aforesaid government vehicle along the National Road coming from Davao City towards Davao del Norte; 3. Upon reaching at Km. Post No.1484 (Barangay Lasang, Davao City) and DLPC Post No. 43180-3335 , I slowed down to avoid hitting another vehicle ahead of the AMBULANCE I was driving when the vehicle following me failed to apply its brake causing such vehicle to bump the rear portion of the said AMBULANCE, and as a consequence thereof, caused an undetermined value of damage of the whole rear portion of such AMBULANCE; 4. The vehicle which bumped the rear portion of the AMBULANCE I was driving was a Nissan Pick-up Double Cab with Plate Number SCH 483, color green, ed under the name of National Irrigation istration (NIA) of Sto. Nino, Carmen, Davao del Norte with CR# 004290 and MVRR # 58963994 and was driven by Fernando Patenio Y Reyes, a resident of Asuncion, Davao del Norte; 5. I attest to the truthfulness of the above facts and I am executing this affidavit for any other legal purpose as it may serve. SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of Davao, Philippines. ZACARIAS S. ORTIZ Affiant SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 2911516 issued on January 14, 1998 at Sto. Tomas, Davao del Norte.
REPUBLIC OF THE PHILIPPINES) ) SS X - - - - - - - -- - - - - - -- - - - - - - -- - --X
T AFFIDAVIT We, NAPOLEON LUMANOG and FLORENTINO MORANTE of legal ages, Filipino, married, and residents of Santo Tomas, Davao del Norte , after having been sworn to in accordance with law, hereby depose and state: 1. That we both personally know the late MODESTO V. DEMABILDO, he being our long-time friend; 2. That we know for a fact that he died on October 14, 1940 at San Carlos City, Negros Occidental; 3. That his death was not recorded in the Civil Registry; 4. That we are not related to him by consanguinity nor affinity and we are executing this affidavit for whatever legal purpose this may serve. IN WITNESS WHEREOF, we have hereunto affix our signature this 21st day of April, 1998 in ________________, Philippines.
NAPOLEON LUMANOG Affiant
FLORENTINO MORANTE Affiant
Subscribed and sworn to before me this ___ day of April, 1998 at ____________, Philippines.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, REYNALDO SAN JUAN OBRA, Filipino, of legal age, married and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that:
1. I am a Medical Representative of GLAXO PHILS. INC. and I was provided by such company with a vehicle which is ed under the name of GLAXO PHILS. INC. The aforementioned vehicle is particularly described, as follows : Make : Mitsubishi L-300 Series : Lancer Motor No.: 4G13A-A7907 Chassis No. : Cb1ASN-04592 Color : Silver Plate No. : TNG-143 2. On June 22, 1998 at about 10:30 a.m., while I was driving the above-described vehicle along the National Road in Buhangin, Davao City, a ten-wheeler truck proceeding opposite to my direction accidently hit a stone; 3. Unfortunately, the stone directly hit the front windshield of the vehicle I was driving causing damage to said windshield; 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. SUBSCRIBED AND SWORN to before me this 26th day of June, 1998 in the City of Davao, Philippines.
REYNALDO SAN JUAN OBRA Affiant
REPUBLIC OF THE PHILIPPINES ) C I T Y O F D A V A O )SS x--------------------------------------------------x
I, LUZ B. PANAGUITON, of legal age, Filipino, single and a resident of Poblacion, Norala, South Cotabato, after having been sworn to in accordance with law, depose and say:
1. That I am a government employee assigned at the Department Education Culture and Sports-Norala, South Cotabato; 2. That I am a member of the Government Service Insurance System (GSIS) and my beneficiary is my mother, Mrs. Margarita Panaguiton; 3. That my 61 year-old mother, Mrs. Margarita Panaguiton, is presently confined at Limso Medical Center due to illness and there is a necessity to avail of the Medicare benefits provided for by law; 4. That I am executing this affidavit in order to attest to truth of the foregoing facts and to apprise the authorities thereof. IN WITNESS WHEREOF, I have hereunto affixed my signature this 15th day of February, 1999 at Davao City, Philippines.
LUZ B. PANAGUITON Affiant SUBSCRIBED AND SWORN to before me this 15th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me her Community Tax Certificate No. 06629947 issued on February 01, 199 at Norala, South Cotabato. Doc.No.113; Page No. 23; Book No. IX; Series of 1999.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, ARMAND C. ALBARRACIN, Filipino, of legal age, single and a resident of GSIS Heights, Matina, Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. That I am an owner of a vehicle which is particularly described, as follows : Motor No. : 4G33-3AR8572 Chasis No. : A173AJL-2920 Plate No. : LAK 394 Series : Lancer Type of Body : Sedan Color : Blue 2. The above-described vehicle is ed in my name. 3. I intend to change its color from Blue to Gray. 4. I attest to the truthfulness of the above facts and I am executing this affidavit for any legal purpose it may serve. SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of Davao, Philippines.
ARMAND ALBARRACIN Affiant SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8060625 issued on January 19, 1998 at Davao City.
Doc. No. _____; Page No. _____; Book No. _____; Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF DAVAO)SS x--------------------------------------------------x AFFIDAVIT I, CARNELL T. TAN, Filipino, of legal age, single and a resident of Davao City, after having been sworn to in accordance with law hereby depose and state that: 1. On July 29, 1998, at around Ten o’clock in the morning, I parked a Milano white Mitsubishi Pajero along Villa Abrille Street, Davao City. The said vehicle is particularly described as follows : Make : Mitsubishi Series : Pajero Motor No. : 4D56A-H4071 Chasis No. : PAEV44WGNVBOO4927 Plate No. : LDK 258 2. The above-described vehicle is ed under the name of my mother, Mrs. Lolita Tan; 3. After parking the car at the place stated above, I went to a nearby store to purchase car accessories; 4. When I returned to the car, I noticed that there was a crack/dent on the center front corner of the car and a deformation of the same; 5. I have no knowledge of facts indicating as to who was responsible for the said damages; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other purposes as it may serve. SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of Davao, Philippines.
CARNELL T. TAN Affiant SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 9738145E issued on May 23, 1998 at Davao City.
Doc. No. _____; Page No. _____; Book No. 1; Series of 1998.
REPUBLIC OF THE PHILIPPINES ) CITY OF D A V A O ) S.S. x--------------------------------------------------x AFFIDAVIT I, ATTY. LEO G. DELOS SANTOS, Filipino, of legal age, married and a resident of No. 071 Cordillera St., Central Park Subdivision, Bangkal, Davao City, after having been sworn to in accordance with the law do hereby depose and states that: 1. I am the ed owner of a ISUZU Fuego Pick-up with Motor Vehicle Registry Receipt No. 08421827 and with Registration Certificate No. CR-41872263. The said vehicle is particularly described as follows : Make Type Color Motor No. Chassis No. Plate No.
: : : : : :
ISUZU FUEGO Pick-up White 580600 PABTFS55HDX200257 LDM-581
3. On February 7, 1999 at about 10:30 A.M., my driver, RICKY GUTIERREZ QUILO and I, were on board the above-described vehicle proceeding to Malita, Davao del Sur; 4. While we were along the highway going to Sta. Cruz, Davao del Sur, a YELLOW BUS proceeding opposite to our direction accidentally hit a stone; 5. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver Side) of my vehicle which caused a crack and damage to the said windshield; 6. I attest to the truthfulness of the above facts and I am executing this affidavit in order to recover insurance proceeds and for other legal purposes it may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th day of February, 1999 in the City of Davao, Philippines.
ATTY. LEO G. DELOS SANTOS Affiant SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02720401 issued on January 4, 1999 at Davao City.
Doc. No. 91; Page No. 18; Book No. IX; Series of 1999.
MARIE JOSEPHINE B. DE VERA Notary Public PTR No. 3949149 01/05/99 Davao City IBP No. 464505 12/29/98 Davao City
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