Republic of the Philippines)

Province of Guimaras )S.S.

X-------------------------------------X

JOINT AFFIDAVIT OF CHANGE BODY TYPE

I, ______________, Filipino, of legal age, married and a resident of
Brgy_______________ Philppines and _______________ of legal age, married and resident of
Barangay _______________, Philippines after being sworn to in accordance with law, depose
and state:

That I,______________, am the registered owner of a certain motor vehicle more

particularly described as follows:

MAKE TYPE : SUZUKI

TYPE OF BODY : PICK UP WITH CANOPY
ENGINE NO. : F6___________
SERIAL/CHASSIS NO : DC______________
PLATE NO. : 07____________
COLOR : BLUE

That I, am going to change the body type engine of the above-mentioned motor vehicle
from pick up w/ canopy to jeepney type.

That I, contracted the service of _______________________, a mechanic by profession

of _________________ to undertake the job of changing the body engine of the motor
vehicle above-mentioned from pick up with canopy to jeepney type.

That, we are executing this affidavit to comply with the requirements of the LTO and
for whatever legal purpose it may serve best.

IN WITNESS WHERE OF, I have hereunto set my hand this ______ day of July, 2019 at
the Province of ______________, Philippines.

________________ ____________________
Owner Mechanic

SUBSCRIBED AND SWORN to before me this _____ day of July, 2019 in the Province
of Guimaras, Philippines. Affiant has exhibited to me his ______________________ as
competent proof of his identity.

Doc No:._____

Page No.:_____ NOTARY PUBLIC

Book No.:____

Series of 2019