Salaya

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REPUBLIC OF THE PHILIPPINES)

CITY OF_______________________ )S.S.

AFFIDAVIT

I, JOHN LOREN C. SALAYA, of legal age, Filipino, and resident of


_____________________________________________, after having been
sworn to in accordance with law hereby depose and state that:

1. That on November 18, 2022, I went to Cavite riding my own


Motorbike, from our residence in Bulacan to accompany my friend
Mr. Romney Christian E. Go and his father MR. ROMAN SANTOS
GO to have his father’s Motorbike tuned-up by his long time
Mechanic in Cavite;

2. That at around 8:19 in the evening on our way to eat dinner at


Tagaytay while traversing from east to west direction along
Tagaytay Calamba Road in Barangay San Jose, Tagaytay City in
front of City land Bldg, while taking the inner/fast lane towards
Tagaytay Rotonda a MONTERO SPORTS WITH PLATE
NUMBER NGM9840, traversing the Tagaytay Calamba Road in
Barangay San Jose, Tagaytay City from west to east direction
Driven by JERWIN AMOS BASBAS, RECKLESSLY AND
NEGLIGENTLY SUDDENLY TURNED LEFT, occupied and
blocked the lane of Mr. Roman Santos Go motorbike which
resulted in a Vehicle Collision between the Motorcycle Bike of
Mr. Roman Santos Go and The Montero Sports;

3. That after the collision, I immediately stop driving and rushed to


check on my friend’s father who was lying motionless on the ground,
on-looker pedestrians also rushed to help and called an ambulance
who immediately responded to the scene of the Vehicular collision
and brought Mr. Go to the nearest Hospital which is the Tagaytay
Medical Center, Inc.;
4. That I am executing this affidavit freely and voluntarily for the
purpose of attesting to the truth of the foregoing statements, to inform
the proper authorities of the above facts, to support the complaint filed
by Mr. Roman Santos Go against JERWIN AMOS BASBAS and for
whatever purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature


this _____________th day of ____________________ 20___ at
______________________________, Philippines.

JOHN LOREN C. SALAYA

Affiant

      SUBSCRIBED AND SWORN to before me this _____ day of


_________________ 20___ in _________________, Philippines. Affiant
exhibited to me his competent evidence of identity
_________________________.

________________________

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