REPUBLIC OF THE PHILIPPINES )

PROVINCE OF OCC. MINDORO ) S.S.

MUNICIPALITY OF SABLAYAN )

AFFIDAVIT OF CHANGE BODY

I, RONALDO C. ACOSTA, of legal age, married, Filipino and with residence at Brgy.,
Buenavista, Sablayan, Occidental Mindoro, after having been duly sworn to in accordance with law,
hereby depose and say:

 That I am owner possessor of a motor cycle particularly described as:

MAKE - KAWASAKI
YEAR MODEL - 2017
ENGINE NO. - DYYWHE04861
CHASSIS NO. - MD2A76BY9HWE51018
BODY TYPE - MOTORCYCLE
MV FILE No. - 0403-00000086934
PLATE NO. - _______________

 That I caused the change of the Body type of the above-described motor cycle from
WITHOUT SIDECAR to WITH SIDE CAR;

 That to legalize the operation of the said motorcycle with sidecar to convey passengers
for fare applied for Franchise to operate the said motorcycle;

That I am executing this affidavit to attest the truth of the foregoing facts and for whatever legal
purposes this may legally serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of Mayo 2019 in Sablayan,
Occidental Mindoro.

RONALDO C. ACOSTA
Affiant

OATH

SUBSCRIBED AND SWORN to before me this 15th day of Mayo 2019 in Sablayan, Occidental
Mindoro, affiant exhibiting to me his I.D No. CRN-0111-1478198-4 issued by Unified Multi-Purpose
I.D.

ATTY. MELVIE E. SILVERIO

Doc. No. ______ NOTARY PUBLIC
Page No. ______ UNTIL DECEMBER 2020
Book No. _____ ATTORNEY’S ROLL NO. 68003
Series of 2020 IBP No. 016948
PTR No. 3357817
MCLE Compliance No. VI-0016804
 VALID UNTIL APRIL 14, 2022
REPUBLIKA NG PILIPINAS)
LALAWIGAN NG OCC. MINDORO)s.s
BAYAN NG SABLAYAN)

SINUMPAANG SALAYSAY
Ako, VOLTAIRE BONILLA, nasa hustong gulang, may asawa, Pilipino at naninirahan
sa Buenavista, Sablayan, Occidental Mindoro, matapos makapanumpa alinsunod sa batas ay
nagsasaad ng mga sumusunod:

1. Na ako ay wilder ng GARCIAWELDING SHOP, na matapgpuan sa Buenavista,

Sablayan, Occidental Mindoro;

2. Na pinatutunayan ko na ako ang gumawa ng sidecar Na pag mamay-ari ni JACOBO D.

DORDAS;

3. Na ako ay nakahandang humarap sa pananagutan sa batas kapag hindi ko nagampanan

ang aking ipinangako sa kasulatang ito;

4. Na ginawa ko ang salaysay na ito upang patunayan ang lahat ng nababanggit dito.

KATUNAYAN NG LAHAT, ay inilagda ko ang aking pangalan sa ibaba nito ngayong

ika- 23 ng Hulyo 2019 dito sa Sablayan, Occidental Mindoro.

VOLTAIRE BONILLA
Nagsasalaysay

PANUNUMPA

SINUMPAAN AT NILAGDAAN sa harap ko ngayong ika- 23 ng Hulyo 2019 dito sa

Sablayan, Occidental Mindoro at lubos kong siniyasat ang nagsasalaysay at pinatutunayan ko na
ito ay malaya at kusang loob niyang salaysay at lubos niyang nauunawaan ang kanyang mga
sinabi sa salaysay niya.

ATTY. MELVIE E. SILVERIO

Doc. No. ______ NOTARY PUBLIC
Page No. ______ UNTIL DECEMBER 2020
Book No. XXIII ATTORNEY’S ROLL NO. 68003
Series of 2019 IBP No. 016948
PTR No. 3357817
MCLE Compliance No. VI-0016804
VALID UNTIL APRIL 14, 2022