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REPUBLIC OF THE PHILIPPINES)

CITY OF __________________)S.S.

AFFIDAVIT OF CHANGE ENGINE

I, ATTY. CHRISTIAN GEORGE LLANES MELITANTE, Filipino, of


legal age, with postal address at c/o Functional, Inc. 814 J.P. Rizal St.,
Makati City, Philippines, after having been duly sworn to in accordance
with law, hereby depose and state: That - -

1. I am the duly authorized Corporate Secretary of FUNCTIONAL,


INC., a corporation duly organized and existing under and by
virtue of the laws of the Republic of the Philippines, with
principal office at the above-mentioned office address;

2. As such Corporate Secretary, I am the custodian of all corporate


records and documents of the corporation;

3. Sometime 27 October 2010, FUNCTIONAL INC. purchased


from K-Mobis Motor Trading Co., Inc. a Hyundai Engine with
stencil number 04BAS944544 per Sales Invoice No. 2972 dated
27 October 2010. As proof thereto, attached hereto as Annex “A”
is a copy of the Certification of Purchased issued by K-Mobis
Motor Trading co., Inc.;

4. The above-mentioned Hyundai Engine with stencil number


04BAS944544 was previously reported and registered by K-
Mobis Motor Trading Co., Inc. to the Land Transportation Office
on 21 October 2010 as per LTO Official Receipt No. 965147455
and Certificate of Stock Reported attached hereto as Annexes
“B” and “C”, respectively;

5. The above purchased Hyundai Engine with stencil number


04BAS944544 is to be utilized as a replacement in the Motor
Vehicle herein described as follows:

Plate No. : UDL-728


Make : Mitsubishi
Series : L300
Type : Van
Model : 1995
Chassis : L039PYZH-00617

A copy of the Certificate of Registration and Official Receipt of


the above-described Motor Vehicle is hereto attached as Annex
“D”;

6. I am executing this Affidavit of Change Engine to attest to the


truth of the foregoing and in support of the application of
FUNCTIONAL INC. for processing of the replacement and/or
change of engine of the above-described Motor Vehicle.

1
IN WITNESS WHEREOF, I have hereunto set my hand this __ th
day of July 2011 at Makati City.

ATTY. CHRISTIAN GEORGE LLANES MELITANTE


Affiant

SUBSCRIBED AND SWORN TO before me, a Notary Public


commissioned in and for the City of Makati this ___ th day of July 2011
by CHRISTIAN GEORGE LLANES MELITANTE, who has
satisfactorily proven to me his identity through Non-Professional
Driver’s License No. N-25-05-012868, bearing his photograph and
signature, valid until November 11, 2011, and that he is the same
person who appeared and signed the foregoing instrument in my
presence within my jurisdiction, and who avowed to the truth of its
content under penalty of law.

NOTARY PUBLIC

Doc. No. ________;


Page No. ________;
Book No. ________;
Series of 2011

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