Republic of the Philippines)

Province of Negros Oriental) S.S.

Municipality of Sibulan . . .)

A F F I D A V I T FOR CHANGE OF BODY OF

MOTOR VEHICLE
I, DINDO AURE VILLACARLOS, of legal age, married, Filipino,
resident of Maslog, Sibulan, Negros Oriental, after having been duly
sworn to in accordance with law, state and declare that:

1. I am a registered owner of a motor vehicle and is more

particularly described as follows:

CHASSIS NO.: MD2A18AY2KWK31321

ENGINE NO. : DUZWKK17414
SERIES: CT100B
DENOMINATION: MOTORCYCLE WITHOUT SIDE CAR
BODY TYPE : MOTORCYCLE
YEAR MODEL: 2019

2. The original body type/denomination of the said motor

vehicle was "MOTORCYCLE WITHOUT SIDE CAR";

3. I have caused the change of body of the above-described

motor vehicle from “MOTORCYCLE WITHOUT SIDE CAR” to
"MOTORCYCLE WITH SIDE CAR";

4. That the change of body type is not intended for any illegal
or unlawful purpose but solely due to the foregoing reasons;

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

foregoing, in support of the application for the change of body
type/denomination of the above-described motor vehicle on its Certificate
of Registration and for all legal intents and purposes;

IN WITNESS WHEREOF, I have hereunto affixed my signature this

28 day of September 2020 in Sibulan, Negros Oriental, Philippines.
th

DINDO AURE VILLACARLOS

(Affiant)

SUBSCRIBED AND SWORN to before me, a Notary Public, on this

28th day of September 2020, for the Municipality of Sibulan and the
Province of Negros Oriental, Philippines, the above-named affiant,
exhibited his BIR ID with TIN: 246-894-528-000, and WHO SIGNED IN
MY PRESENCE the foregoing document (Affidavit for Change of Body of
Motor Vehicle), and who avows under PENALTY OF LAW to the whole
truth of the contents of the same

Doc No. 27;

Page No. 8;
Book No. II;
Series of 2020.