REPUBLIC OF THE PHILIPPINES)

CITY OF PASAY ) S.S.

x------------------------------------x

AFFIDAVIT FOR CHANGE OF BODY OF MOTOR VEHICLE

I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, 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 : ________________

Motor Number : ______________

Chassis Number : ____________

Plate Number : _______________

MV File No. : _________________

Year Model :__________________

Color : _______________________

2. The original body type of the said motor vehicle was "_____________";

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

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 ___________________ in Pasay City, Metro Manila, Philippines.

__________________________

Affiant

SSS ID No. _____________

SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence of identity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;

Page No. _____;

Book No. _____;

Series of 2013.