REPUBLIC OF THE PHILIPPINES )

Province of Nueva Ecija ) S.S.

Science City of Munoz )

AFFIDAVIT OF ATTACHMENT OF SIDECAR

I, MAXIMO P. DOMINGO,SR., of legal age, Filipino and presently

residing at Barangay Bakal III, Talavera, Nueva Ecija, after having been sworn to
in accordance with law, hereby depose and state, THAT:

1. That I am the registered owner of one (1) unit motorcycle more

particularly described as follows:

MAKE: RUSI
MV FILE: 0101-00000454975
ENGINE NUMBER: RF158FMIH4AD58979
BODY TYPE: MC
YEAR MODEL: 2017

2. That recently, I have attached a sidecar to said motorcycle which

attachment was included in the registration.

3. That the installation/attachment of said sidecar had been given in a

full consideration of its safety and worthiness of all passengers.

4. That I personally supervise the installation and attachment of the

sidecar into the above described motorcycle.

5. That I personally assumed all liabilities in case of any findings of

negligence in the actual attachment of the sidecar to the
motorcycle.

6. That I therefore assure the road worthiness and safety of the

assembled tricycle.

7. That I am executing this affidavit to attest to the truth of the

foregoing statements and for all legal intents and purposes..

IN WITNESS WHEREOF, I have hereunto affixed our signature this

November 22, 2019 at Science City of Muñoz, Nueva Ecija.

___________________________
MAXIMO P. DOMINGO,SR.,
Affiant
 SUBSCRIBED and SWORN to before me this November 22, 2019 at
Science City of Muñoz, Nueva Ecija and I hereby certify that the affiant has read
the contents of his affidavit and understands the same.

Doc. No.: 255;

Page No.: 52;
Book No.: VII;
Series of 2019.