REPUBLIC OF THE PHILIPPINES }

PROVINCE OF }
MUNICIPALITY OF _____________ } S.S.

AFFIDAVIT FOR GOOD FAITH

We, the undersigned MORTGAGOR AND MORTGAGEE hereby jointly and

severally swear that we executed the foregoing Chattel Mortgage for the purpose of
securing the obligation/s specified in the provisions hereof, and for no other purpose
and that the same is/are just valid obligation/s and not entered into for the purpose of
fraud.

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

____________ 2021 in _____________________, Philippines.

_________________________ _________________________

Mortgagor Mortgagee
ID No. ID No.
Issued on: Issued on:
Place of Issue: Place of Issue:

SUBSCRIBED AND SWORN to before me at_______________________,

Philippines this _____ day of ___________, 2021, affiant exhibiting before me her
Competent Evidence of Identity written below her name and signature, that she is the
same person who personally signed before me the foregoing Affidavit and
acknowledged that she executed the same.