REPUBLIC OF THE PHILIPPINES )

CITY OF ) S.S

AFFIDAVIT OF WARRANTY

I, _______________________________, Filipino of legal age, with principal address at

___________________________________________________, having been duly sworn in accordance
with law hereby depose and say

That I am the new owner of one (1) motor vehicle, which is more particularly described as follow:

MAKE : ______________________
TYPE : ______________________
MOTOR NO. : ______________________
CHASSIS NO. : ______________________
PLATE NO. : ______________________
MV FILE NO. : ______________________

That the above described motor vehicle was acquired from ____________________ with address at
________________________ based on Deed of Absolute Sale dated ______________________.

That I hold free and non-liable and Land Transportation Office personnel from any claim at whatever
kind and nature with respect to the registration of the above described motor vehicle together will all the
documents relative to any title of ownership over the same.

That I execute this affidavit freely and voluntary and for whatever legal purpose it may serve

FURTHER AFFIANT SAYETH NONE:

IN WITNESS HEREOF, I have hereunto set my hand and affixed my signature this ______ day of
__________________, 2021.
Digitally signed by
De Guzman
Christian Menard
Inson
___________________________
Affiant

SWORN TO BEFORE ME, on the day, year and place first above written

Doc No. ______________

Page No.______________
Book No._____________
Series of 20_________