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Affidavit for Vehicle Plate Issue

Warren Lualhati Asendido files an affidavit of mutilation regarding the license plate of his 2010 Mitsubishi vehicle with plate number NQQ819. He states that while parking his car, something hit the front bumper and the next morning he discovered the first letter of the plate number was missing and the plate was torn and unable to be found. He files this affidavit to attest to the facts for insurance claims purposes.

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262 views1 page

Affidavit for Vehicle Plate Issue

Warren Lualhati Asendido files an affidavit of mutilation regarding the license plate of his 2010 Mitsubishi vehicle with plate number NQQ819. He states that while parking his car, something hit the front bumper and the next morning he discovered the first letter of the plate number was missing and the plate was torn and unable to be found. He files this affidavit to attest to the facts for insurance claims purposes.

Uploaded by

TRĀP3ZØÎD GÆMÏNG
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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REPUBLIC OF THE PHILIPPINES }

STO. TOMAS, BATANGAS } S.S.

AFFIDAVIT OF MUTILATION

I, WARREN LUALHATI ASENDIDO, Filipino, of legal age, married,


a resident of #25 Brgy. Lawaguin, Nagcarlan, Laguna after being sworn in
accordance with law, hereby depose and say:

1. That I am the holder of a Non-Professional Drivers License No. D12-


14-000279 Issued by the LTO of Calamba, Laguna and valid until
February 17, 2019;

2. That I am the owner of a vehicle more particularly described below:

Make: Mitsubishi
Year Model:2010
Plate No.: NQQ819
Motor No. 4D56AAC6160
Chassis No. PAEVB5MH99B000451
CR No. 265383720
OR No. 1436547232

3. That while I was about to park my car something hit the front
bumper;

4. That following morning I discovered that the plate number has been
dilapidated and the first letter was missing.

5. That the plate number was torn which I cannot be found;

6. That I execute this AFFIDAVIT to attest to the veracity of the facts


stated herein and for insurance claims purposes.

Done this __________________________ at Sto. Tomas, Batangas.

WARREN L. ASENDIDO
Affiant

SUBSCRIBED AND SWORN to before me this 4TH day of Januaty 2019 at


Sto. Tomas, Batangas, Philippines, affiant exhibiting to me his competent proof
of identity.

Doc. No. : ________;


Page No. : ________;
Book No. : ________;
Series of 2019.

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