REPUBLIC OF THE 

PHILIPPINES)
CATANAUAN, QUEZON PROVINCE) S.S.
x------------------------------------x
  

AFFIDAVIT OF CHANGE OF BODY

OF MOTOR VEHICLE

 I, GLENDA B. LEOVIDO, of legal age, Filipino, and a resident of Barangay San
Antonio Pala, Catanauan, Quezon Province, after having been duly sworn to in
accordance with law, depose and state that:

1. I am the registered owner of a motor vehicle which is particularly described as

follows:
    
             Make & Type :  Yamaha
             Engine Number : E3R2E-3132802
             Chassis Number : PA0SE9810N0660973
             MV File No. : 0472-00000233498
Series: MIOl125BB38
Certificate of Registration No. 44983416-2
Denomination: MOTORCYCLE WITHOUT SIDE CAR
Year Model: 2022

2. The original body type of the said motor vehicle is: "Motorcycle without Side
Car";

3.  I have decided to change the body type of the said vehicle from "Motorcycle
without side car" to "with side car";

4. The change of body type is not intended for any illegal or unlawful purpose;

5. 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 14th day of

November 2022 in Catanauan, Quezon Province, Philippines.

GLENDA B. LEOVIDO
Affiant

 SUBCRIBED AND SWORN TO before me this 14th day of November 2022 in

Catanauan, Quezon Province, Philippines. The affiant exhibited to me her identification
card issued by Professional Regulation Commission, with Registration No.:0588913 valid
until 29 January 2025, as competent evidence of identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2022.