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Republic of the Philippines)

__________________ ) s.s.
x-------------------------------------------x
AFFIDAVIT OF OWNERSHIP WITH AUTHORITY TO USE

I, __________________, of legal age, Filipino citizen, married and with residence and postal
address at ________________________, after having been duly sworn in accordance with law do hereby
depose and say:

That I am the true and absolute owner of two (2) motor vehicles which are more
particularly described as follows:

That I hereby warrant title and ownership over the above-mentioned motor vehicle, and attached
hereto are machine copies of the OR/CR as Annexes “A” and “B”;

That I am authorizing _____________________ to use the above-described vehicles for his


intended ____________________ business and to turn over to him the administration and maintenance of
the same;

That I am executing this Affidavit to attest to the truth of the forgoing facts for any legal purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______ day of December
2017 at ____________________________, Philippines.

________________________
Affiant
CEI:
SUBSCRIBED AND SWORN to before me this __________________ at
______________________, affiant exhibited himself to me his valid ID bearing his photograph and
genuine signature as competent proof of his identity pursuant to the 2004 Rules on Notarial Practice.