affidavit sample

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I, Jose Rafael Bartolome, was hit by a rock while crossing the PNR railroad tracks in Espana Avenue at 11:30 PM on April 17, 2015. No other vehicle was involved in the incident and I was not able to get the identity of where there rock came from as it was dark. I am attaching the picture of the damage with this form. Here are my contact details: Cellular - 09152489793 Landline - 4364299

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Page 1: Affidavit Sample

I, Jose Rafael Bartolome, was hit by a rock while crossing the PNR railroad tracks in Espana Avenue at 11:30 PM on April 17, 2015. No other vehicle was involved in the incident and I was not able to get the identity of where there rock came from as it was dark. I am attaching the picture of the damage with this form.

Here are my contact details:Cellular - 09152489793Landline - 4364299

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