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That I, ____________, of legal age, Filipino, married, and with residence in Garsika,
Makilala, Cotabato, Philippines the owner of a tricycle, which is more particularly described as
follows:
Make : KAWASAKI
Denomination : Tricycle
Body Type : TC hire
Series : _______________
Chassis No. : ____________
MV File No. : __________
Engine No. : ________________
Plate No. : _______________
___________________ ___________________
Vendor Vendee
______________________________ UMID # ______________________
______________________________ _________________________
ACKNOWLEDGMENT
BEFORE ME, Notary Public, for and in _____________________, this ______ day of
_________________, personally appeared the above parties with their competent proof of
identities as indicated above, known to me to be the same persons who executed the foregoing
instrument and acknowledged to me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and place above written.
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