REPUBLIC OF THE PHILIPPINES )

PROVINCE OF )
MUNICIPALITY/CITY OF ) S.S

ACKNOWLEDGEMENT OF OWNERSHIP

I, ________________, of legal age, single/married, Filipino citizen and a resident of

___________________, after having been duly sworn to in accordance with law do hereby
depose and state:

1. That I am the present registered owner of a certain HONDA motorcycle bearing, Plate
No. __________, Motor No. ___________, Chassis No. ____________, with sidecar
covered by Certificate of Registration No. _______________;

2. That although I am the named registered owner of the aforesaid motorcycle with sidecar,
I do hereby declare as a matter of public record that __________________ is the true and
lawful owner, he being the actual owner of the money used in buying the same;

3. That I am only the owner of the franchise used therein;

4. That I am executing this document as a means of acknowledging _____________ as the

lawful, true and rightful owner of the above motorcycle with sidecar for all legal
purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _____ 2022
Laoag City, Ilocos Norte, Philippines.

______________________________
(Affiant)
(ID No._______________)

SUBSCRIBED AND SWORN to before me, in the city/municipality of __________, this

_________ day of 2022 by ___________ with (ID and ID number) issued at _____ on ______
2022.

Doc No.
Page No.
Book No.
Series of 2022