Republic of the Philippines)

Province of La Union ) S.S.

City of San Fernando )
X------------------------------X

JOINT-AFFIDAVIT OF OWNER AND MECHANIC FOR

CHANGE OF ENGINE OF MOTOR VEHICLE

WE, JAIME C. GONZALES, of legal age, Filipino citizen, married, a resident of

and with postal address at Brgy. Baroro, Bacnotan, La Union, Philippines and
ROMEO ABUAN, of legal age, Filipino citizen, married, a resident of and with postal
address at 315 Brgy. Paringao, Bauang, La Union, Philippines, after having been duly
sworn to in accordance with law, hereby depose and say that;
1. I, JAIME C. GONZALES, is the owner of a certain registered motor vehicle with
the following particular descriptions as follows, to wit:
Make : HONDA
Body : SEDAN-4-DOOR
Series : CIVIC
Model : 2000
Serial/Chassis No. : PADEK1540YV204753
Original Engine No. : P6FD1P504786
MV File No. : 1320-00000183360
Original CR No. : 2443734-6
Plate No. : WLH 920
2. I recently caused the change of engine of the above-described motor vehicle and
the automotive mechanic who was contracted to effect the engine change is the
Chief Mechanic of TIRE FACTORS CORP., ROMEO ABUAN with business
address at National Highway, Sevilla, San Fernando City, La Union, Philippines;
3. The owner and mechanic named/described herein made the foregoing
statements under oath and in good faith in order to establish the fact of the
change of the old engine of the subject motor vehicle as described above from
P6FD1P504786 to VAAN20465; and
4. Both owner and mechanic executed this Affidavit voluntarily to attest to the
truth of the foregoing facts based on personal knowledge and authentic records
and in compliance with the requirement of the Land Transportation Office (LTO)
to cause the necessary change in the registration of the above-described motor
vehicle and for all legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand on this ___ day of
___________________, 2021 in the City of San Fernando, La Union, Philippines.

JAIME C. GONZALES ROMEO ABUAN

Affiant/Owner Affiant/Mechanic
VIN ID NO. 3303-0025A-E1969JCG10000-8 PDL ID NO. A04-86-015678; VALID UNTIL 12/11/22
(COMELEC, Bacnotan, La Union) (LTO – San Fernando City, La Union)

SUBSCRIBED AND SWORN TO before me this ___ day of ________________, 2021

at San Fernando City, La Union, Philippines, both affiants exhibited to me their
competent proof of identity bearing their signatures and pictures as stated above,
below their signatures and printed names.

____________________________
Notary Public
Doc. No. ;
Page No. ;
Book No. ;
Series of .
1|P a g e Joint-Affidavit of Owner and Mechanic for the Change of Engine of
Motor Vehicle