DACION EN PAGO

KNOWN ALL MEN BY THESE PRESENTS:

That I, of legal age, Filipino,
single/married, and residing at
hereby consents to and voluntarily give-
up to by way of dacion the
herein below described motor vehicle in view of my failure to faithfully pay my loan payment:

MAKE
TYPE
ENGINE NO.
CHASSIS NO.
PLATE NO.

This Dacion en Pago is hereby executed to transfer and cede ownership of the motor vehicle
above described to
to be sold or
disposed to other person(s) interested, in any manner considered beneficial and/or advantageous to the
interest of the said company.

SIGNED IN THE PRESENCE OF:

WITNESS WITNESS

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in

personally appeared the herein party and who
acknowledge the same his/her voluntary act and deed and made for the use and purpose therein set forth.
WITNESS MY HAND AND SEAL on the date and in the place first above written.

Doc. No.
Page No.
Book No.
Series of 2020.