REPUBLIC OF THE PHILIPPINES )

CITY OF CEBU ) S.S.

A F F I D AV I T
------------------

I, , of legal age, Filipino, single and with office address at City, Philippines
after having been duly sworn to in accordance with law, hereby depose and state:
That –

1. I am the chief mechanic of (hereinafter referred to as), a corporation

organized and existing under the laws of the Philippines, with principal
place of office at Philippines, 6000;

2. I was authorized and instructed by to transfer the engine of a motor

vehicle more particularly described as follows:

a. CR No/RRPL. _______________;
b. OR No. ;
c. Make: ________________;
d. Model: _______________;
e. Classification: Private Utility Vehicle/UV/GAS;
f. Plate No.:;
g. Chassis No.:;
h. MV File No.; and
i. Engine No.:.

3. The engine of the above-described vehicle was transferred to a Toyota

owned and maintained by (hereinafter referred to as), with principal
place of office at 2 City and more particularly described as follows:

a. CR No./RRPL _______________;
b. OR No. ______ ;
c. Make: ;
d. Model: ;
e. Classification: Private Utility Vehicle/DIESEL;
f. Plate No.: ;
g. Chassis No.: ;
h. MV File No.: ;
i. Motor No. .

4. I am executing this affidavit to establish and attest to the truthfulness

of the foregoing facts and for all other legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my signature this ___

September 2017 in Cebu City, Philippines.

______________________________
ROBERTO SOLLANO MILANA
Affiant

SUBSCRIBED AND SWORN to before me this ___ September 2017 in Cebu City,
the affiant personally appearing before me and personally identified to me by his
competent evidence of identification as follows: SSS ID No. ____________________.

Notary Public