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Republic of the Philippines)

City of Dumaguete )S.S.


x-------------------------------------/

AFFIDAVIT OF CHANGE BODY OF MOTOR VEHICLE

I, LUIS DECIN ALOS, Filipino, of legal age, married, and a resident of


Northern Junob, Dumaguete City, after having been sworn to in accordance
with law, do hereby depose and state that:

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


particularly described as follows:
Make : Honda
Series : TMXS2
Plate No. : GC 43332
Engine No. : KYA00E047064
MV File No. : 0701-00000093158
Chassis No. : KYA00047024
C.R. No. : 204993880
2. The original body type of the said motor vehicle was “MOTORCYCLE
WITHOUT SIDECAR”;

3. To have more use of the said motor vehicle, I have installed an open cage
sidecar without roof, sometime 2019;

4. Thus, the body type of said motor vehicle is now changed from
“MOTORCYCLE WITHOUT SIDECAR” to “MOTORCYCLE WITH
SIDECAR”;
5. The change of body type is not intended for any illegal or unlawful
purpose, but solely for the foregoing reasons;

6. I am executing this Affidavit to attest to the truth of the foregoing facts


and declarations 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 affixed my signature this
____________________________, in the City of Dumaguete, Philippines.

LUIS DECIN ALOS


Affiant
SSS ID No. 071454622-9

SUBSCRIBED AND SWORN to before me this __________________________


at Dumaguete City, affiant exhibited to me his competent proof of identity as
shown above.

Doc. No. ______; Page No. ______;


Book No. ______; Series of 2020.

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