Joint Affidavit: Change - Body Design

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

REPUBLIC OF THE PHILIPPINES

CITY OF BACOLOD -------------------) S.S


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

JOINT AFFIDAVIT
Change _Body Design_

I, BRION P. TA-ALA, representative of TA-ALA FARMS, INC, of legal age, Filipino Citizen,
and resident of Felisa Rd. Mansilingan, Bacolod City, Philippines and REY ESTIMAR, of legal age,
Filipino Citizen, and a resident of Bacolod City, Negros Occidental, Philippines after having been
duly sworn to in accordance with law, do hereby depose and say;

1. That I BRION P. TA-ALA is the AUTHORIZED representative of TA-ALA FARMS, INC., with
postal and business address at Felisa Rd. Mansilingan, Bacolod City, Negros Occidental,
which is the registered owner of motor vehicle more particularly, described follows

Make & Type : TRUCK/FUSO/WING VAN TRUCK


Motor Number : 6M61-008027
Chassis Number : FK61HS-750009
Plate Number : ADK 4205

2. That I have change the body design of the MOTOR VEHICLE of TA-ALA FARMS, INC address
Brgy. Felisa Rd. Mansilingan Bacolod City, (Philippines) Negros Occidental Philippines;

3. That I have change the body design of the aforementioned motor vehicle from
____CANOPY WING VAN_____ TO _______CHICK VAN TRUCK_________

4. That I have hired the services of REY ESTIMAR, of Bacolod City, Philippines;

5. That we both executing this JOINT affidavit to attest to the fact and veracity of the
foregoing and request the PNP for the necessary clearance for us.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______ day of


____________ 201_ at _______________, Philippines.

__BRION P. TA-ALA__ ____REY ESTIMAR___


Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of _________, 201_ at


________________________, Philippines.

Doc. No. _____,


Page No._____,
Book No._____,
Series of 201__,

You might also like