Affidavit for Change of Body of Motor Vehicle) Republic of the Philippines) Province of ________________)S.S.

City/Municipality of _____________) x-------------x AFFIDAVIT I, _____________, Filipino, of legal age, (single / married / widow), and a resident of _____________, Philippines, after being sworn to in accordance with law, depose and state: 1.That I am the registered owner of a certain motor vehicle that is more particularly described as follows: Make:Motor No.: Type:Chassis No.: Series:Plate No.: 2. That the original body type of the said motor vehicle was "____________"; 3. That 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. That the change of body type is not intended for any illegal or unlawful purpose but solely due to the foregoing reasons; 5. That 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 _____________, Philippines. AFFIANT (JURAT)