REPUBLIC OF THE PHILIPPINES)

MALOLOS CITY, BULACAN )SS.

AFFIDAVIT FOR CHANGE OF BODY

OF MOTOR VEHICLE

I, CONRADO MATEO MATUS of legal age, Filipino citizen, a resident of No. 06 Ipil
Street Purok II C Maysan, Valenzuela City, after having been sworn to in accordance with
law hereby depose and say that:

1. I am the owner of a certain registered motor vehicle, with the particular

description as follows, to wit:

MAKE: HONDA PLATE NO.: 130308

BODY TYPE: MOTORCYCLE CHASSIS NO.: KYA01E054496
SERIES: TMXS2G MV FILE NO.: 1303-00000509165
MODEL: 2017

2. The original body type of the said motor vehicle was “WITHOUT SIDE CAR” as
appearing in the LTO Certificate of Registration No. 288558592;

3. To have more use of the said motor vehicle in order to earn a living, I have
decided to change the body type of the said motor vehicle from “WITHOUT SIDE
CAR” to “WITH SIDE CAR”;

4. The change of body type is not intended for any illegal or unlawful purpose but
solely due to the foregoing reason;

5. That I therefore have executed this Affidavit to cause the necessary changes in
the registration above-mentioned vehicle in the Land of Transportation Office, to
attest the truth I mentioned herein and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this day of _______________

at MALOLOS CITY, BULACAN

CONRADO MATEO MATUS

Affiant

SUBSCRIBED AND SWORN to before me this day of ___________ at MALOLOS CITY,

BULACAN

Doc. No. _____;

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