REPUBLIC OF THE PHILIPPINES….

)
PROVINCE OF NEGROS ORIENTAL) S.S.
DUMAGUETE CITY …………………. )

AFFIDAVIT
I, ASTERIO GARGAR KINILITAN, of legal age, Filipino, married with residence and postal
address at Bagacay, Dumaguete City, Negros Oriental, Philippines, after having been duly sworn to in
accordance with law, under oath, hereby say THAT:

1. I am the registered owner of a motor vehicle, which motor vehicle is more particularly
described as follows:

MAKE/TYPE: LONCIN MC
ENGINE NO.: RZ150FMG-287300283
CHASSIS NO.: RZ150FMG-207300039
CR NO.: 5369902-6
MV FILE NO.: 0728-00000102673
PLATE NO.: T55096

2. As per Certificate of Registration of the said motor vehicle my name was erroneously registered
as “ASTERO” GARGAR KINILITAN instead of “ASTERIO” GARGAR KINILITAN;

3. I am one and the same “ASTERO” GARGAR KINILITAN and “ASTERIO” GARGAR
KINILITAN;

4. I have the intention to apply for the correction of my name as appearing to be the registered
owner of the aforesaid vehicle, from “ASTERO” GARGAR KINILITAN to “ASTERIO” GARGAR
KINILITAN, which the latter is my true and correct name that should have been reflected on the said
certificate of registration. This true and correct name of mine is evinced by my identification cards and
other pertinent documents;

5. I am executing this affidavit to attest the veracity of our foregoing statements and for whatever
legal purpose this might serve best.

IN WITNESS WHEREOF, I hereunto set my hand this ___________ in Dumaguete City,

Philippines.

ASTERIO GARGAR KINILITAN

Affiant
Driver’s License No. G02-17-004590

SUBSCRIBED AND SWORN to before me this ______________ in Dumaguete City, Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.