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AFFIDAVIT OF UNDERTAKING (FOR VECHILE)

I, Mr XYZ JY; son of XYZ JY a resident of 1A/14, 3rd Floor, PPC FLAT, NOLAMBUR, CHENNAI 600056 after having been duly sworn to in accordance with law, hereby voluntary depose and say: That I am owner of the bike "Hero Honda Passion Plus" having Month & year of Manufacture as 06/2006. The bike is having Chassis No. is 06E09C99999 and the Engine No 06E08M999. Currently the bike Registration No. is AP 13BD 4007 having registration number. Class of Vehicle: Motor Cycle Maker's Classification: HERO HONDA PASSION PLUS OWNER: Self Owned Month & Year of Manufacture: 06/2006 Chassis No: 06E09C99999 Engine No: 06E08M999 Fuel Used: Petrol Here with I am submitting require documents to the RTO office. And I declare that all the documents provided by me related to my vehicle are true to my knowledge. That I am executing this affidavit to attest all the above facts as mentioned and to do re-registration for the above said motor cycle bike.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____________ at _____________ Philippines.

OWNER

SIGNED IN THE PRESENCE OF:

__________________

__________________

REPUBLIC OF THE PHILIPPINES) CITY/MUNICIPALITY OF ______) SS. x------------------------------------x ACKNOWLEDGMENT BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of _____________, personally appeared _____________ with Community Tax Certificate No. _____________ issued on _____________ at _____________, personally known to me (or whom I have identified through competent evidence of identity) and who represented to me that his/her signature on the foregoing instrument was voluntarily affixed by him/her for the purposes stated in the instrument and who declared that he/she has executed the foregoing instrument as his/her free and voluntary act and deed. This Instrument consists of only ______ (____) page/s, including this page in which this acknowledgment is written, duly signed by _____________ and his/her instrumental witnesses on each and every page hereof. WITNESS MY HAND AND SEAL this _____________ at _____________, Philippines.

NOTARY PUBLIC Doc. No. ______; Page No. ______; Book No.______; Series of 20____.

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