Republic of the Philippines)

La Trinidad Benguet--------)
X--------------------------X
AFFIDAVIT OF LOSS
I, AGUSTIN GALAP MATIKID, of legal age, married, Filipino
citizen, with residence and postal address at Baculongan Norte,
Buguias, Benguet, Philippines, after having been duly sworn to in
accordance with law, hereby depose and state that:
1. I am the registered owner of a motor vehicle with
Certificate of Registration No. 17194004 and was registered
in my name in the Land Transportation Office (LTO) in la
Trinidad, in the year 2007 and was renewed on October 22,
2009 under Official Receipt No. 619537240 which is more
specifically described as:
MAKE : Isuzu
BODY TYPE : Pick-up
ENGINE NO : 4BB1-318486
PLATE NO : PSA 670
CHASSIS NO : TLD53-7614767
2. However, the original back plate number was inadvertently
lost sometime on August 01,2005 when the said vehicle was
traversing from Baculongan Norte to Abatan, Buguias while
delivering my sick cousin at Bekes Emergency Hospital;
3. I exerted diligent efforts to find and locate the said back
plate but to no avail. Further, my efforts is in vain and
now I consider the same irretrievably lost and beyond
recovery;
4. Said license plate was not confiscated, revoked and or
cancelled by any law enforcement authority for violation of
any traffic laws, rules and regulations;
5. If the DOTC thru the LTO/LTFRB, after inquiry, has found me
responsible for the unauthorized use of the herein reported
lost plate, I hereby signify my conformity to be meted the
administrative fined and penalties due and imposed thereon;
6. I am executing this affidavit to attest to the veracity of
the foregoing narration of facts and for all legal intents
and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th

day of November, 2009 at La Trinidad, Benguet, Philippines.

AGUSTIN GALAP MATIKID

Affiant
SUBSCRIBED AND SWORN to before me this 19th day of November,
2009 at La Trinidad, Benguet, Philippines. The affiant presented
his CTC No; 213221752 issued on 11-19-09 at La Trinidad, Benguet,
signed the foregoing instrument in my presence which he
acknowledged before me as his free and voluntary act and deed.

DOC.NO: 87 ATTY. JAKE AWAL SAGPAEY

PAGE NO: 18 Notary Public
BOOK NO: I until December 2010
IBP NO: 7887704/BAGUIO-BENGUET/04-21-09
PTR NO: 6564808/BENGUET/05-27-09
ROLL NO: 57226
SERIES OF 2009
Republic of the Philippines)
La Trinidad Benguet--------)
X--------------------------X

AFFIDAVIT OF CHANGE OF COLOR

I, AGUSTIN GALAP MATIKID, of legal age, married, Filipino

citizen, with residence and postal address at Baculongan Norte,
Buguias, Benguet, Philippines, after having been duly sworn to in
accordance with law, hereby depose and state that:

1. I am the registered owner of a motor vehicle with

Certificate of Registration No. 17194004 and was
registered in my name in the Land Transportation Office
(LTO) in la Trinidad, in the year 2007 and was renewed on
October 22, 2009 under Official Receipt No. 619537240
which is more specifically described as:

MAKE : Isuzu
BODY TYPE : Pick-up
ENGINE NO : 4BB1-318486
PLATE NO : PSA 670
CHASSIS NO : TLD53-7614767

2. I, together with the assistance of other mechanics, have

caused the change of its color from multi-colors to yellow
with red stripe;

3. I am executing this affidavit to attest to the veracity

of the foregoing narration of facts in support of my
application for registration before the Land
Transportation Office at La Trinidad, Benguet and for all
legal intents and purposes it may legally serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th

day of November, 2009 at La Trinidad, Benguet, Philippines.

AGUSTIN GALAP MATIKID

Affiant
SUBSCRIBED AND SWORN to before me this 19th day of November,
2009 at La Trinidad, Benguet, Philippines. The affiant presented
his CTC No; 213221752 issued on 11-19-09 at La Trinidad, Benguet,
signed the foregoing instrument in my presence which he
acknowledged before me as his free and voluntary act and deed.

ATTY. JAKE AWAL SAGPAEY

Notary Public
Until December 2010
IBP NO: 7887704/BAGUIO-BENGUET/04-21-09
PTR NO: 6564808/BENGUET/05-27-09
ROLL NO: 57226
DOC.NO: 88
PAGE NO: 18
BOOK NO: I
SERIES OF 2009

Republic of the Philippines)

La Trinidad Benguet--------)
X--------------------------X

AFFIDAVIT OF CHANGE OF BODY DESIGN

I, AGUSTIN GALAP MATIKID, of legal age, married, Filipino

citizen, with residence and postal address at Baculongan Norte,
Buguias, Benguet, Philippines, after having been duly sworn to in
accordance with law, hereby depose and state that:

1. I am the registered owner of a motor vehicle with

Certificate of Registration No. 17194004 and was
registered in my name in the Land Transportation Office
(LTO) in la Trinidad, in the year 2007 and was renewed on
October 22, 2009 under Official Receipt No. 619537240
which is more specifically described as:

MAKE : Isuzu
BODY TYPE : Pick-up
ENGINE NO : 4BB1-318486
PLATE NO : PSA 670
CHASSIS NO : TLD53-7614767

2. I together with the assistance of skilled mechanics, have

caused the changed of the body design of the above
mentioned vehicle from ELF PICK-UP TO ELF PICK-UP WITH PIPE
RAILING;

3 I am executing this affidavit to attest to the veracity of

the foregoing narration of facts in support of my
application for registration before the Land Transportation
office at La Trinidad, Benguet and for all legal intents
and purposes it may legally serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 19 th

day of November, 2009 at La Trinidad, Benguet, Philippines.

AGUSTIN GALAP MATIKID

Affiant
SUBSCRIBED AND SWORN to before me this 19th day of November,
2009 at La Trinidad, Benguet, Philippines. The affiant presented
his CTC No; 213221752 issued on 11-19-09 at La Trinidad, Benguet,
signed the foregoing instrument in my presence which he
acknowledged before me as his free and voluntary act and deed.
ATTY. JAKE AWAL SAGPAEY
Notary Public
Until December 2010
IBP NO: 7887704/BAGUIO-BENGUET/04-21-09
PTR NO: 6564808/BENGUET/05-27-09
ROLL NO: 57226
DOC.NO: 89
PAGE NO: 18
BOOK NO: I
SERIES OF 2009
Republic of the Philippines)
La Trinidad Benguet--------)
X--------------------------X
 AFFIDAVIT OF MECHANIC/PAINTER

I, MARVEN D. TINO, of legal age, Filipino citizen, with

residence and postal address at Poblacion, La Trinidad, Benguet,
Philippines, after having been duly sworn to in accordance with
law, hereby depose and state that:

1. I and AGUSTIN GALAP MATIKID, the registered owner of a

motor vehicle with Certificate of Registration No. 17194004
and was registered in my name in the Land Transportation
Office (LTO) in la Trinidad, in the year 2007 and was
renewed on October 22, 2009 under Official Receipt No.
619537240 which is more specifically described as:

MAKE : Isuzu
BODY TYPE : Pick-up
ENGINE NO : 4BB1-318486
PLATE NO : PSA 670
CHASSIS NO : TLD53-7614767
Have caused the change of the body design and color of the
above-mentioned vehicle.

2. As a mechanic I installed the pipe railing of the said

motor vehicle and also helped in the change of its color
from MULTI-COLORS TO YELLOW WITH RED STRIPE;
3. I am executing this affidavit for the purpose of stating
the fact that I have caused the change in the Body
design and color of the above-mentioned vehicle for the
purpose of registration.
4. Further, I am executing this affidavit to attest to the
veracity of the foregoing narration of facts and for
whatever legal intents and purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 19 th
day of November, 2009 at La Trinidad, Benguet, Philippines.

MARVEN D. TINO
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 23rd day of October,

2009 at La Trinidad, Benguet, Philippines, Affiant exhibiting his
Professional Driver’s license No. A01-91-032538, bearing his
photograph and signature signed this Affidavit in my presence and
avowed under penalty of law to the whole truth of the contents of
the foregoing Affidavit.

DOC.NO: 90 ATTY. JAKE AWAL SAGPAEY

PAGE NO: 18 Notary Public
BOOK NO: I until December 2010
SERIES OF 2009 IBP NO. 7887704/ BAGUIO-BENGUET/ 04-21-09
PTR NO.6564808/BENGUET/05-27-09
ROLL NO. 57226