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REPUBLIC OF KENYA

IN THE MATTER OF STATUTORY DECLARATION ACT 15


LAWS OF KENYA
AFFIDAVIT

I, SIMON GITHINJI NGATIA, of post office Box 13098-00200, NAIROBI within


republic of Kenya, holder of Identification Card: do hereby make Oaths and state as
follows:-

1. THAT I am of sound mind hence competent to swear this affidavit.

2. THAT I am the owner of a motor vehicle registration number KCH041E


SUBARU S.WAGON.

3. THAT I have decided to change the engine block from EJ20-D781380 to EJ20-
D440840.

4. THAT I therefore Request the Commissioner and the Registrar of motor


vehicles to effect the changes and issue another logbook.

5. THAT I swear this affidavit conscientiously believing everything contained


herein is true and in accordance with Oaths and statutory declaration Act CAP
15 of the laws of Kenya
Sworn at Nairobi by the said

SIMON GITHINJI NGATIA )


)
This…………day of………, 2017 )
)
) ________________
) DEPONENT

BEFORE ME

COMMISSIONER OF OATHS