REPUBLIC OF THE PHILIPPINES }

MUNICIPALITY OF } S.S.
METRO MANILA }

AFFIDAVIT OF WARRANTY WITH UNDERTAKING

That I, ____________________________________, of legal age, Filipino

and resident of _______________________________________________________
____________________________________________________, after having been
duly sworn do hereby depose and say:

1. That I am the lawful owner of that certain motorvehicle/motorcycle

which is more particularly described as follows:

MAKE: ___________ MOTOR NO.: _______________________

TYPE: ___________ MODEL: _______________________

PLATE NO.: ___________ CHASSIS No. _______________________

2. That I am presently applying for registration For:

_________________________________________ of the above described
motorvehicle/motorcycle with the LTO with my capacity as
______________________.

3. I hereby unconditionally warrant absolute title and ownership over

the above described motorvehicle/motorcycle and I hereby declaim
the same is free from any liens, suits, claims or encumbrances
whatsoever or any matter may prove adverse thereof.

4. I hereby release the Land Transportation Office (LTO), its officials,

staff and personnel any suits, claims or liabilities which may arise
from the approval of the said applicant motorvechicle/motorcycle
registration or any process or matter pertinent thereto and in the
event, suit, claim or liability.

5. I hereby undertake to defend such title as well as assume such

suits or claims resulting there from without cost charge or liability
whatsoever according the Land Transportation Office, its Officials,
its staff and personnel.

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

of _________________ at Pateros, Metro Manila.

_____________________________
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of

______________ at Pateros, Metro Manila with Affiant affixing his/her
signature in my presence and within my notarial jurisdiction.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2021