Republic of the Philippines)

Province of Masbate ) S.S.

City of Masbate )

AFFIDAVIT OF WARRANTY & ACKNOWLEDGEMENT

I, Francis H. Toribio, of legal age, Filipino, and a resident of Sitio Matungao.Brgy. Tugbo,
Masbate , after having been duly sworn to in accordance with law, hereby depose and say:

1. That I am the buyer of the said vehicle 1 unit HONDA FIT with Plate No. KFZ 396;

2. That I FULLY PAID Two Hundred Twenty Thousand Pesos cash( Php 220,000.00) for the said
Vehicle. Receipt was hereby acknowledged by the seller Edision V. Du. Attached hereto is
the receipt of the said transaction as Annex A.

3. That I wish to manifest that the said vehicle was sold to me last October 10, 2016.

4. That I have executed this affidavit to attest to the truth of all the foregoing and satisfy the
inquiry or requirements of any person or office particularly the Land Transportation Office
and for other legal purpose.

IN WITNESS WHEREOF, I have hereunto set my hands this ____________________ in the City of
Masbate, Philippines.

__________________________
Affiant

JURAT

SUBSCRIBED AND SWORN to before me this _______day of ________________________at

Masbate City. Affiant exhibited to me his Drivers license no. EO4-11-001353 with expiry date on Jan.
20, 2019.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2017;