Affidavit of Damage

I, , of legal age, single and residing at Sta Rita Olongapo City, after having
been duly sworn to in accordance with law, do hereby depose and say;

That I am the authorized driver of Pacific Metalworks Corporation with a

certain motor vehicle more particularly described as follows:

Make and Type : Daewoo

Motor Number : D2366-100047
Serial Number : KN3NAP7MILK001096
Plate Number : MCT 282
MV File Number : 1248-8953

That I am holder of Professional Driver’s License with license Number:

C09-95-052135.

That on August 26, 2008, I was driving the truck when I accidentally
slightly hit Toyota Fortuner with plate number ZLK 892 which is present at
premises of PAMECO that had caused it’s damage at the right side corner of the
car;

That the accident and incident was not reported to the police and ;

That I am executing this affidavit to attest to the truth of the foregoing

facts to whatever legal purpose it may serve.

Affiant Further Sayeth Naught

JOVENCIO ALABADO JANDOG

Affiant

Subscribed and Sworn to before me this 27th day of August in Marikina City,
Philippines.