Republic of the Philippines)

City of Dumaguete )
x-------------x

AFFIDAVIT FOR CHANGE OF BODY OF MOTOR VEHICLE

I, QUEENIE RAMOS, Filipino, of legal age, single and a resident of

Mangnao, Dumaguete City, Philippines, after being sworn to in accordance
with law, depose and state:

1.That am the owner of a certain motor vehicle that is more particularly

described as follows:

Make: YAMAHA Motor No.: 4PF-175385

Type of Body: MC Chassis No.: 4PF-175385

CR No.: 73254058 Plate No.: GY-7342

2. That I have acquired the said vehicle from its registered owner per Deed
of Absolute Sale of Motor Vehicle dated 20 February 2019, duly
notarized by Atty. Gracelyn Bellingan-Bennett and docketed in her
notarial register under Doc. No. 304; Page No. 61; Book No. IV; Series
of 2019.

3. That the above mentioned vehicle had been registered as “MC” and once
been used for public utility, which has been dropped already;

3. That as new owner, I have decided to change the body type of the said
vehicle from being an “MC” to a private vehicle, particularly
"MOTORCYCLE WITH SIDE CAR";

4. That the change of body type is not intended for any illegal or unlawful
purpose but solely due to the foregoing reasons;

5. That I am executing this Affidavit to attest to the truth of the foregoing and
in support of the application for the change of body type of the
above-described motor vehicle on its Certificate of Registration.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of

March 2019 in Dumaguete City, Philippines.

0991

QUEENIE RAMOS

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of March 2019 at

Dumaguete City, affiant exhibiting to me her TIN with no. 408-530-279-000
as competent proof of his identity.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 21019.