You are on page 1of 1

Republic of the Philippines )

City of Butuan ) S.S.


x-------------x

AFFIDAVIT

I, ADONES MUSICO, Filipino, of legal age, single, and a resident of P-4 Manapa,
Buenavista, Agusan del Norte after being duly sworn in accordance with law, depose and state:

1. That I am the authorized representative of RIC Z. LAURIO, the owner of a


motor vehicle particularly described as:

Make & Type : Honda


Engine No. : XRM13E111433
Chasis No. : XRM13111432
Plate No. : KS3683
MV File No. : 1520-00000045252
Year Model : 2007

2. This is to manifest that Mr. RIC Z. LAURIO has sold the said motor vehicle
to MR. JONNEFER ARGALLON last April 13, 2015 for a consideration
amounting to Php 25,000.00.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________


Butuan City, Philippines

ADONES MUSICO
LTO ID NO. : KO1-14-000949

SUBSCRIBED AND SWORN TO before me this ______________________, affiant


exhibiting to me his government issued I.D. with his picture and signature appearing thereon.

Doc. No.____;
Page No.____;
Book No.____;
Series of 2019.

You might also like