Republic of the Philippines )

City of Legazpi ) s.s.

x---------------------------------------------x

AFFIDAVIT
I, NHA AKS C. DENTE, minor, Filipino citizen, single and a resident of Bahay St., House
Subdivision, Legazpi City, assisted by my mother, Inah C. Dente, after having been duly sworn
in accordance with law, do hereby depose and state, that:
1. On or about 3:30 pm of July 28, 2017, I was already at home from my school at University
of Sto. Tomas- Legazpi City.
2. Since I have a project due next week and my mother, Inah C. Dente texted me for an
errand to check our food supplies and to buy some with the money she left if the
supplies were no longer sufficient for the weekend. Since it was a Friday and my other
family members were not yet around from work and school, I took my helmet and drove
the blue Kawasaki motorcycle of our family to LCC Express Mart-House Subdivision
Branch, the nearest grocery store from our house.

3. While I was driving along Sitio Kanto, Gilid, Legazpi at a minimum speed, a white 2017
Mistsubishi Delica suddenly arrived opposite my direction and collided with the
motorcycle I drove.

4. The next thing I knew, I was already in a hospital bed at an Intensive Care Unit of Aquinas
University Hospital. My mother informed that I got involved in a vehicular accident and
have undergone several surgeries due to serious head injuries I suffered from the
accident. From time to time, she would ask me if I remember anything before I got
injured.

5. I told my mother that I never overtook a van before the accident in contrast with the
allegations of NHAM BANGGA, driver of the 2017 Mistsubishi Delica.
6. I attest to the truthfulness of the above-statements in support of the criminal complaint
filed by my mother Inah C. Dente against NHAM BANGGA.
Signed this 29th day of September 2017 at Legazpi City.

NHA AKS C. DENTE

Affiant
Student Driver’s License No. E01-12-12345
Issued by LTO
Assisted by his mother Inah C. Dente

INAH C. DENTE
PRC ID No. 001234

SUBSCRIBED AND SWORN to before me this 29th day of September 2017 at Legazpi
City, Philippines. Affiants exhibited to me their Identification Cards indicated below their
name bearing their photographs and genuine signatures as competent proof of their identity
pursuant to the 2004 Rules on Notarial Practice.

Doc. No. 123;

Page No. 26; ATTY. CZABINA FATIMA DELICA
Book No. 16; NOTARY PUBLIC
Series of 2017. FOR AND IN THE PROVINCE OF ALBAY
PTR NO. 1234567; 01/03/2017; LEG. CITY
IBP NO. 1234566; 01/03/2017; ALBAY
ATTORNEY’S ROLL NO. 610116
MCLE Comp. V-0012345 VALID FROM 01/13/2016
Until 01/13/2019; ISSUED ON FEBRUARY 2, 2015
SERIAL/DOCKET NO. NP-2016-02
TEL. NO, (052)742-4803