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Chattel Mortgage - Form
Chattel Mortgage - Form
That the MORTGAGOR does hereby convey by way of chattel mortgage unto the
MORTGAGEE the following described motor vehicle, now in my possession, to wit:
MAKE : Fuso
SERIES : Dump
TYPE OF BODY : Truck
MOTOR NO. :
SERIAL/CHASSIS NO. :
PLATE NO. :
That this CHATTEL MORTGAGE is given as security for the payment to the
MORTGAGEE, for the credit line (a maximum of 500 sacks of rice) of the MORTGAGOR, he,
being a Distributor of the merchandise of the MORTGAGEE.
That the conditions of this CHATTEL MORTGAGE are such that if the said
MORTGAGOR, her heirs, executors, or administrators shall well and truly perform the full
obligation above stated according to the terms thereof, then this chattel mortgage shall be null
and void otherwise, it shall remain in full force and effect and shall be enforceable in the manner
provided for by law.
IN WITNESS WHEREOF, the Mortgagor has hereunto set his hand, this ________ day
of _____________________, 2019, in Cebu City, Philippines.
_______________
Mortgagor
Signed in the presence of:
1. ______________________________ 2. ________________________________
ACKNOWLEDGMENT
This instrument, consisting of two (2) pages, including the page on which this
acknowledgement is written, has been signed on the left margin of each and every page thereof
by the Mortgagor and Mortgagee and their witnesses, and sealed with my notarial seal.
IN WITNESS WHEREOF, I have hereunto set my hand, the day, year and place above-
written.
-2-
AFFIDAVIT OF GOOD FAITH
We, the undersigned MORTGAGOR and MORTGAGEE, severally swear that the
foregoing chattel mortgage is made and executed for the purpose of securing the obligation
specified in the conditions thereof, and for no other purpose, and that the same is just and valid
obligation, and one not entered into for the purpose of fraud.
That the conditions of this CHATTEL MORTGAGE are such that if the said
MORTGAGOR, her heirs, executors, or administrators shall well and truly perform the full
obligation above stated according to the terms thereof, then this chattel mortgage shall be null
and void otherwise, it shall remain in full force and effect and shall be enforceable in the manner
provided for by law.
IN WITNESS WHEREOF, the Mortgagor has hereunto set her hand, this ________ day
of November, 1999, in Cebu City, Philippines.
CARMENCITA HERMOSA
Mortgagor
CTC No. ______________________
______________________________
1. ______________________________ 2. ____________________________
-2-
ACKNOWLEDGMENT
BEFORE ME, this ______ day of November, 1999, in Cebu City, Philippines, personally
appeared CARMENCITA HERMOSA, with Community Tax Certificate shown above, known
to me to be the same person who executed the foregoing instrument and she acknowledged to me
that the same is her free act and deed.
This instrument, consisting of two (2) pages, including the page on which this
acknowledgement is written, has been signed on the left margin of each and every page thereof
by the Mortgagor and Mortgagee and their witnesses, and sealed with my notarial seal.
IN WITNESS WHEREOF, I have hereunto set my hand, the day, year and place above-
written.
Doc. No. _______
Page No. _______
Book No. _______
Series of 1999
SUBSCRIBED AND SWORN to before me this _____ day of November, 1999, in Cebu
City, Philippines, affiants exhibited to me their Community Tax Certificates shown above.