Republic of the Philippines )

) s.s.
x---------------------x

AFFIDAVIT OF ATTACHED SIDECAR

I, PALMA M. SALAYA, of legal age, Filipino, married, and a resident of Brgy.

Lumangan, Miagao, Iloilo, after having been duly sworn to in accordance with law,
hereby depose and state that:

1. I am the registered owner of a motor vehicle, further described as follows:

Make : Kawasaki
Series : BC175H
Type : Motorcycle without a side
car
Engine Number : BC175AELC9421
Chassis Number : BC175H-B07708
MV File Number : 0601-00000301314
OR Number : 002017119146717
Certificate of Registration No. : 275410284

2. Recently, I have caused the attachment of a sidecar, which attachment was not
included in the registration.

3. This affidavit is executed to change the Body Type of said motorcycle to

Motorcycle with Sidecar and attest to the truth of the foregoing facts and
circumstances and in support of my request to change the entry in the body type
section to Motorcycle with Sidecar in the vehicle’s OR/CR with the Land
Transportation Office.

IN WITNESS WHEREOF, I have hereunto set my hand this February 15, 2019 at
Miagao, Iloilo.

PALMA M. SALAYA
Affiant

SUBSCRIBED AND SWORN TO before me this 15th day of February, 2019 at

Miagao, Iloilo, affiant exhibited to me her DILG ID with number 063030068-01(2) issued
by the Department of Interior and Local Government (Miagao, Iloilo), containing her
signature and picture.