REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO )
X-------------------------------------------X

JOINT AFFIDAVIT FOR CHANGE OF BODY DESIGN

I, __ ATANASIO C. GUADALUPE JR._____ of legal age, Filipino and a resident of

NHA MANDURRIAO ILOILO CITY______Iloilo City, Philippines, do hereby depose and
say:

That I am the registered owner of a motor vehicle described as _SUZUKI SUPER

CARRY UV__with Motor No. _______E08AN1009618________and Chassis
No.___MA3DA33T8H0101320___. File No. __0601-332406___and Temp. Plate No.
___060109__ paid under OR No. __1223816425____in the amount of_ 7,097.18___.

That I decide to change the body design of my said motor vehicle from CAB
CHASSIS__ into a ___UTILITY VAN______ type.

That I have engaged the service of a mechanic and body builder by profession into of
____JORGE E. TA-ALA___ with a shop located at _____SUZUKI AUTO ILOILO____ to
change the body design from __ CAB CHASSIS __to ___ UTILITY VAN ___type.

That the job of a mechanic and body builder was already completed and ready for
registration with the LTO Office.

That we are executing this affidavit in order to attest the above stated facts and to secure
a Clearance from PNP TRAFCOM. Camp Delgado, Iloilo City.

IN WITNESS WHEREOF; I have hereunto set my hand this __________ day of

___________________2017 in the City of Iloilo, Philippines.

__ JORGE E. TA-ALA__ __ATANASIO C. GUADALUPE JR.__

Senior Technician Owner

SUBSCRIBED AND SWORN to before me is ___________ day

of___________________ 2017 in the City of Iloilo, Philippines.

Doc. No. ___________,

Page No. ___________,
Book No. ___________,
Series of ___________,