REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ________________ )SS.

MUNICIPALITY OF ___________)
x----------------------------------------------------x

AFFIDAVIT OF CHANGE OF BODY DESIGN

I, __________________________, of legal age, single, Filipino and a

resident of Barangay __________________________, after having been
duly sworn to in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle under Official Receipt Number

__________________________ and Certificate of Registration Number
__________________________, particularly described as follows:

Make: Yamaha
Engine No: __________________________
Chassis No: __________________________
Denomination: __________________________

That the original body type of the said motor vehicle is “Motorcycle without
Sidecar”;

That to have more use of the said vehicle, I have decided to change the
body type/design of the said vehicle and hired a mechanic to assemble a side
car for my motorcycle to become a “motorcycle with sidecar”;

That the change of the body/design of the aforesaid motor vehicle was not
intended for any illegal or unlawful purpose but solely for the foregoing
reasons;

That I am executing this Affidavit to attest to the truth of the foregoing and
in support of my application for the change of body type/design of the above-
described motor vehicle on its Certificate of Registration.

IN WITNESS WHEREOF, I hereto set my hand this 25th day of July, 2018
at __________________________

__________________________
Affiant
DL No. _________________

SUBSCRIBED AND SWORN to before me this 25th day of July, 2018

at __________________________