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AFFIDAVIT OF GOOD FAITH We, the undersigned mortgagor and mortgagee, severally swear that the foregoing chattel

mortgage is made and executed for the purposes of securing the obligation specified therein, and for no other purpose, and that the same is just and valid obligation, and one not entered into for the purpose of fraud.

JUAN DELA CRUZ JR. Mortgagor BIR Card with TIN 123-456-789

JUANA S. REYES Mortgagee BIR Card with TIN 321-654-987

REPUBLIC OF THE PHILIPPINES ) CITY OF LAS PIAS )ss. SUBSCRIBED AND SWORN to before me this _____________ at _____________________ by the affiants who exhibited their IDs indicated below their names and signatures as competent proof of identity.

Doc No. Page No. Book No. Series of _____

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