AFFIDAVIT

I, _____________, Filipino, of legal age, (single / married / widow), and a resident

of _____________, Philippines, after being sworn to in accordance with law,
depose and state:

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

particularly described as follows:

Make:Motor No.:

Type:Chassis No.:

Series:Plate No.:

2. That the original body type of the said motor vehicle was “____________”;

3. That to have more use of the said vehicle in my business, I have decided to
change the body type of the said vehicle from “_____________” to
“_____________”;

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 _____________ in

_____________, Philippines.