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REPUBLIC of the PHILIPPINES )

CITY of BAGUIO ) S.S.

AFFIDAVIT

I, CYNTHIA INGOSAN DE TORRES, of legal age, married,


Filipino citizen, and with postal address at No. 30 Lower Kitma Road,
Bakakeng Central, Baguio City, Philippines, after having been sworn to in
accordance with law, do hereby depose and state that:

1) I am the owner of an Isuzu NQR, particularly described as


follows:

CS No.: CL 3921
Chassis No.: PABN1R71RL000793
Engine No.:4HG1217701A;

2) There was a change of Body Design in the above described


vehicle, wherein a Dumptruck was constructed completely on July
23, 2014 by Multi-Lift Sales Corporation;

3) I am effecting this Affidavit in compliance with the


requirements of the Land Transportation Office for the registration
of the aforementioned vehicle;

4) I am executing this Affidavit to attest to the truth of the


foregoing, to satisfy the requirements of the proper government
agency, and for all legal intents and purposes that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 9 th


day of September 2014, at Baguio City, Philippines.

CYNTHIA INGOSAN DE TORRES


Affiant
Postal ID No. 3400299
Issued By: UB – Post Office, Baguio City
Valid Until: April 2016

SUBSCRIBED and SWORN to before me, a Notary Public, this


th
9 day of September 2014, in the City of Baguio, Philippines. Affiant
exhibited to me her government-issued identification card, bearing her
photograph and signature, the details of which appearing below her name.
The affiant avowed to the truthfulness of the foregoing statements.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2014.

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