Você está na página 1de 1

Republic of the Philippines )

City of Cagayan de Oro ) Ss


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

AFFIDAVIT

I, RENATO R. BATINGAL, Filipino, married and a resident of Bocboc, Don


Carlos, Bukidnon, upon my oath, do hereby depose and state, That:

1. I am the same Renato R. Batingal who accidentally hit one Buenaben Duran Butac in
the afternoon of June 22, 2010 at the Don Carlos, Bukidnon National Highway while
in transit to Kadingilan, Bukidnon.

2. On said date, I was personally driving my Mitsubishi Delica Van more particularly
described below as follows:

Make : Mitsubishi
Series : Delica
Type of Body : Van
Model : 2004
Color : Black
Chassis No. : P35W-0311115
Motor No. : 4D56-FT4830

3. This affidavit is executed to attest to the fact that I was personally driving the
aforementioned VAN while the June 22, 2010 accident occurred.

IN WITNESS WHEREOF, I have hereunto set my hand this 20th day of July
2010, City of Cagayan de Oro, Philippines.

_____________________
RENATO R. BATINGAL
Affiant
LTO License No. K03-06-000078
Issued on: April 8, 2009

SUBSCRIBED AND SWORN to before me this July 20, 2010, at Cagayan de Oro City,
Philippines. I certify that I have examined the Affiant and I am satisfied that he voluntarily executed the
foregoing Affidavit and that the contents thereof had been fully explained to him and understood by him
before he affixed his signature thereon.

Doc. No. 415


Page No. 82
Book No. 1
Series of 2010.

Você também pode gostar