Republic of the Philippines)

City of Cebu..) S.S.

AFFIDAVIT
I, __________________, of legal age, Filipino, married and a resident of
Cebu City, after having been duly sworn to in accordance with law hereby
depose and say, THAT:

1. I parked my Honda Civic (2015) Car with Plate No. ______________ at

the parking area of _____________________ on November 1, 2017;

2. When I returned to the parking area at around 9:00 oclock in the

morning on the same day, I noticed the paint scratches at the two
doors (drivers side) of my car, as can be shown by the pictures that
I took immediately after I saw the scratches, attached hereto and
marked as Annex A;

3. Prior to parking at the said area, my car had no scratches

whatsoever;

4. I figured that someone might have either accidentally or deliberately

scratched my car while it was parked;

5. There are no CCTV cameras in the area, hence, I have no idea who
is responsible or who caused the damage to my car;

6. I am executing this affidavit to attest to the veracity of the foregoing

facts and for whatever legal purpose that this affidavit may serve.

IN WITNESS WHEREOF, I hereby affix my signature this ___th day of

___________ 2017 at Cebu City, Philippines.

______________________
Affiant

SUBSCRIBED AND SWORN to before me this __________________ at

Cebu City, Philippines. Affiant personally appeared and exhibited to me his
______________ issued on _____________ at _____________and valid
__________________.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2017.