Republic of the Philippines
Municipality of Echague) s.s
Province of Isabela)
AFFIDAVIT OF DAMAGE TO VEHICLE
I, JONATHAN B. DONATO, Filipino, of legal age, married and a resident of
Barangay Silauan Norte, Echague, Isabela after having been duly sworn to in accordance
with law, hereby depose and state that:
1. I am a duly licensed driver with Driver’s License No. B04-97-038753, which is
valid until October 5, 2024;
2. I am the authorized driver of a government vehicle van owned and registered
by Isabela State University Main Campus with address at Echague, Isabela
which is more particularly described as follows:
Make
:
Chassis Number :
Engine Number :
Color
:
Plate Number :
2019 TOYOTA HIACE COMMUTER VAN
JTFJT02P4K5021839
1kd2862928
WHITE
P2X 223
3. On January 30, 2023, at about 9 o’clock in the morning, I was driving along the
highway of Castillo, Echague, Isabela and in front of me was a dump truck
loaded with gravel;
4. That while I was driving the aforementioned vehicle, a stone fell of the said
truck and hit the van I was driving and as a result the said vehicle sustained a
minimal damage at its windshield;
5. I am executing this affidavit to attest to the truth of the foregoing statements
and for all legal intents and purposes it may serve.
In WITNESS WHEREOF, I have hereunto affixed my signature this 31st day of
January 2023 at Echague, Isabela.
JONATHAN B. DONATO
Affiant
SUBSCRIBED AND SWORN to before me on this 31st day of January 2023 in
Echague, Isabela affiant having exhibited to me his Driver’s License with number B0497-038753 valid until October 5, 2024 as his competent proof of identity.
Doc No.: _________
Page No.: ________
Book No.: ________
Series of 2023