STATEMENT OF FACTS

사실확인서·진술서 · EN

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STATEMENT OF FACTS DECLARANT Name: Kim Mokgyeok ID / DOB: 880303-1****** Address: 7 Ooo-dong, Seoul, Korea Contact: +82-10-2222-3333 Relationship to case: Witness DATE / PLACE around 10 p.m. on September 1, 2026 / a crosswalk on Ooo-ro, Gangnam-gu Statement At the time stated above, I witnessed a black sedan run a red light, strike a pedestrian crossing the crosswalk, and flee the scene without stopping. I declare that the foregoing is a true and accurate account of facts within my personal knowledge. September 14, 2026 Declarant: Kim Mokgyeok ________________ To: Seoul Gangnam Police Station

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진술인 성명생년월일·식별정보주소연락처사건 관련인과의 관계진술 대상 일시·장소진술 내용제출처작성 일자
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