Republic of the Philippines)

City of Naga )s.s.

AFFIDAVIT OF WARRANTY/UNDERTAKING

I, , Filipino, of legal age and resident of , after having been sworn in

accordance with law, hereby depose and state that:

1. I am the lawful owner of a certain motor vehicle particularly described as

follows:

MAKE & TYPE : ______________________________

MOTOR NO. : ______________________________
CHASSIS NO. : ______________________________
PLATE NO. : ______________________________

2. I am presently applying for the registration/transfer of the aforesaid

motor vehicle in my name before the LAND TRANSPORTATION OFFICE (LTO).

3. In my capacity ____________________________, I hereby unconditionally

warrant the absolute title and ownership over the above-described motor vehicle, and I
hereby declare that the same is free from any liens, suits, claims or encumbrances
whatsoever, or any matter which may prove adverse thereto.

4. I hereby release the LAND TRANSPORTATION OFFICE (LTO), its officials,

staff and personnel from any suits, claims or liabilities which may arise from the
approval of the said application for motor vehicle registration or any process or matter
pertinent thereto and in the event of any suit, claim or liability, I hereby undertake to
defend such title, as well as assume and satisfy any such suits or claims resulting
therefrom, without cost, charge or liability accruing to the Land Transportation Office,
its officials, staff and personnel.

5. I am executing this Affidavit to attest to the truth of the foregoing facts,

in connection with my application for the registration/transfer of the above-described
motor vehicle, and for whatever legal purpose that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

January 2020 in Naga City, Philippines.

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of January 2020 in

Naga City, Philippines. Affiant exhibited to me his/her ______________, bearing her
photograph and signature, to prove to me that he/she is the same person who signed
and executed the foregoing Affidavit.

Doc No. ____

Page No. ____
Book No. ____
Series of 2020