REPUBLIC OF THE PHILIPPINES )

PROVINCE OF __________ )S.S.

MUNICIPALITY OF _______ )
x------------------------------------------------x

WAIVER
I, _________________________, of legal age, Filipino Citizen, single/married and a resident
of _______________________, after having been duly sworn to in accordance with law, do
hereby deposes and states that:

I am the same person executing this affidavit of waiver;

I bought a motorcycle at MOTORSTAR PROBIKES MOTORCYCLE CENTER, ________

Branch, __________, Isabela;

MODEL --------------
________________
ENGINE NO. --------------
________________
FRAME NO. --------------
________________
SALES INVOICE NO. --------------
________________
DATE --------------
________________

I understand that the “No OR/CR, No Travel Policy” which states the said
motorcycle only be driven or used in the buyer’s place of residence.
Furthermore, I am fully aware that the said motor vehicle can be used and
driven in the private roads while the OR/CR is being processed. It cannot,
however be used for driving on public roads such as major thoroughfares and
highways.

Furthermore, If I will be apprehended by Land Transportation Office (LTO), TMG,

PASOC, Philippine National Police (PNP) and any other related government
agencies concern, by way of this instrument, I do hereby waive, release,
discharge, covenant not to sue, MOTORSTAR PROBIKES MOTORCYCLE CENTER,
________ Branch, __________, Isabela, their board of directors, officers, and
employees free from any penalties/liability as it is my solely fault;

I am executing this affidavit freely and voluntarily without having been forced,
coerced and/or intimidated, and with the sole purpose to waive, release,
discharge, covenant not to sue, in favor of MOTORSTAR PROBIKES MOTORCYCLE
CENTER, ________ Branch, __________, Isabela;

I hereby attest to the truth of the foregoing for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

______________ at _________________

__________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ______________ at

_________________.
affiant exhibited to me his/her Driver’s License No._________________ valid until
_____________.
Doc. No.____
Page No.____
Book No.____ Notary Public
Series of ____