REPUBLIC OF THE PHILIPPINES }

LIPA CITY, BATANGAS } S.C.

AFFIDAVIT
I, JIMMY LASIG SALES, of legal age, Filipino, married, and
with residence address at A. Bonifacio St., Poblacion Bargy. 10
Lipa City, Batangas, after having been duly sworn to in accordance
with law, depose and state that:

1. I am the owner of a certain motor vehicle with

Certificate of Registration No. 195686783 and more particularly
described as follows:

MAKE : RUSI
SERIES : TC-125
MV FILE : 0448-00000196554
PLATE NO. : DZ 11571
DENOMINATION : MOTORCYCLE WITH SIDE CAR

2. The original Denomination of said motor vehicle was

“MOTORCYCLE WITH SIDE CAR”;

3. However, I have decided to use the said motor vehicle as

my son’s mode of transportation from home going to work;

4. By this, I have caused the same to change the

Denomination of the said motor vehicle from “MOTORCYCLE WITH SIDE
CAR” to “MOTORCYCLE” only;

5. I further attest that the change of the denomination is

not intended to any illegal or unlawful purpose but solely due to
the foregoing reasons;

6. I am executing this Affidavit to attest the veracity of

my foregoing statements and for whatever legal purpose it may
serve;

AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this

_______________ here at Lipa City, Batangas.

JIMMY LASIG SALES

Affiant

SUBSCRIBED AND SWORN to me this _________________ here at

Lipa City, Batangas affiant exhibiting to me his ID with
No._______________ bearing his photograph and signature as his
proof of identification.

WITNESS MY HAND AND SEAL on the date and place first mentioned
above.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2019.