Professional Documents
Culture Documents
a. Make: Suzuki
b. Series: Swift 1.2 AT
c. MV File No.: 0701-00000630850
d. Plate No.: GOD 916
4. That I am executing this affidavit to file a claim against my insurance policy and
for other legal purposes.
IN WITNESS HERETO, I affix my signature below this ___ day of ____ 2018 in
the __________________, Philippines.
AUGISTINO R. NEGRO
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ____ day of _______ 2018 in the
_________________, Philippines; affiant presented to me her competent proof of identity
ID No.: ____________ issued at _________________ on ___________________.
NOTARY PUBLIC
Doc No. ___
Page No. ____
Book No. ____
Series of 2018