REPUBLIC OF THE PHILIPPINES)

LAOAG CITY )S.S.

AFFIDAVIT

I, MCKLEINE WALLY A. PASCUAL, of legal age, Filipino citizen, married

and with residence and postal address at Brgy. 32-A, La paz, Laoag City,
having been sworn in accordance with law, hereby depose and state that:

That I am the absolute registered owner of a motor vehicle with Official

Receipt No.18335, and more particularly describe as follows:

Make : Motorcycle Type of Body : Solo Motorcycle

Engine No : QT16ZKMK4626380 Serial Chassis No: BPEL003GB725201
Model : Hyper Brusco 175 Color : Black

That the body of the said motorcycle will be change to Motorcycle with sidecar. .

I execute this Affidavit to prove that the said motorcycle change to

Motorcycle with Sidecar for private used;

I attest to the veracity and truthfulness of the foregoing statements with

my voluntary acts and deeds for all lawful purposes and legal intents it may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3rd

April 2017 at Laoag City, Philippines.

MCKLEINE WALLY A. PASCUAL

Affiant
Driver’s License No.A03-06-000865
Valid until January 27,2018

SUBSCRIBED AND SWORN to before me this 3rd April 2017 at Laoag

City, Philippines; affiant presenting to me his identification abovementioned as
proof of his identity; and I certify further that I have personally examined the
affiant and I am satisfied that he voluntarily executed the same and
understood the contents thereof.

Doc. No. 270 ;

Page No. 45 ;
Book No. I;
Series of 2017.