REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO ) S.S

x ------------------------------------x

AFFIDAVIT OF TRANSFER

I, NELSON D. PINEDA, Filipino, of legal age, married and a resident of Phase 2A,Ciudad
De Hizon, San Agustin, San Fernando, Pampanga, Philippines, after being duly sworn in
accordance with law, depose and state:

1. That I am the nephew of my deceased uncle, Federico Dizon David ;

2. That my uncle owned a .45 Caliber Pistol with Serial Number: SC01082811 registered
under his name. As evidence, I attached herewith a copy of the Certificate of Firearms
Registration marked as Annex “A”;

3. That the heirs of my uncle wants to transfer the said firearm under my name;

4. That I have all the qualifications to possess the said firearm. As evidence, I herewith
attached the copy of my Certificate of License to Own and Possess Firearms as
Annex “B”;

5. That I al

6. That the purpose of this affidavit is to comply with the requirements of the law for the
transfer of said firearm under my name;

7. As such, I am executing this Affidavit of Transfer to attest to the truth of the foregoing.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at

____________________________Philippines.

NELSON D. PINEDA
AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public this ___th day of ____________
20___. Affiant personally came and appeared with his Driver’s License No.C10-89-060774 issued
at San Simon, Pampanga, expiring on _______________bearing his photograph and signature,
known to me as the same person who personally signed the foregoing instrument before me and
avowed under penalty of law to the whole truth of the contents of said instrument.

Doc. No.____;
Page No.____;
Book NO.____;
Series of 2019.