REPUBLIC OF THE PHILIPPINES

QUEZON CITY, METRO MANILA

)
) S.S.

AFFIDAVIT OF WARRANTY
I, ALAN TAN, of legal age, Filipino and a resident of No.
255 G. Araneta
Ave.,Quezon City, after having been duly sworn to in accordance with law, hereby
depose and say:
1.

That I am the lawful owner of that certain motor vehicle which is more
particularly described as follows:
MAKE & TYPE
MOTOR NO.
SERIAL NO.
FILE NO.
PLATE NO.
MODEL

:
:
:
:
:
:

Suzuki Vitara
G16B-591350
TDOIV-PH002619
1372-207375
WHD 641
1999

2.

That the above-described motor vehicle was sold to me by a person

named Moroo Shino as per attached Deed of Sale of Motor Vehicle
notarized before Notary Public Atty. Ma. Teresa Gomez-Valdez of Quezon
City;

3.

That I hereby warrant that I am the true and lawful owner of the said
vehicle and that by this instrument, I hereby absolve the personnel of the
LTO of any liabilities which may hereafter arise out of the issuance of a
new Certificate of Registration of the said vehicle under my name;

4.

That I hereby guarantee that the said vehicle is free from any liens and
encumbrances whatsoever.

5.

That I have executed this affidavit to attest to the truth of all the foregoing
and to satisfy the inquiry or requirements of any person or office and for
other legal purpose it may serve.

ALAN TAN
Affiant
SUSBCRIBED AND SWORN to before me this 12 th day December, 2006 at
Quezon City, affiant exhibited to me his Res. Cert. No. _______________ issued on
_________________ at __________________.

Doc. No. ________;

Page No. ________ ;
Book No. ________ ;
Series of 2006.

REPUBLIC OF THE PHILIPPINES)

QUEZON CITY, METRO MANILA ) S.S.

AFFIDAVIT
I, YOLANDA C. PLAMO, of legal age, Filipino and a resident of Luzon Ave.,
Diliman, Quezon City, after having been duly sworn to in accordance with law, hereby
depose and say:
1. That I am the claimant for the SSS Funeral Claim of my nephew DEXTER P.
GAVANES who died as a bonafide SSS member on March 16, 1999;
2. That, a Funeral Claim Check and Voucher under Claim Ref. no. C6055778
with a net amount due of FIFTEEN THOUSAND PESOS (P15,000.00) was
issued in my name by the Social Security System, East Avenue, Quezon City;
3. That in the encashment of said Check I am being required by the drawee
bank, that is, the Philippine National Bank (PNB), SSS Diliman Branch, to
present valid identification cards which bears my signature, thus, I presented
my Postal ID, but the same was not accepted;
4. That I wish to declare and manifest that I have no other available identification
card to be presented except my Postal ID but I have papers and documents
to show that I am that YOLANDA C. PLAMO, referred to in that Funeral
Claim Check issued by the SSS; photocopies of which are hereto enclosed
for your reference;
5. That I hereby request for the immediate encashment of said check and that I
hereby absolved the personnel of the PNB, SSS Diliman Branch and so with
its officials of any future liabilities/responsibilities arising out of this
undertaking;
6. That I have executed this affidavit to attest to the truth of all the foregoing and
to satisfy the inquiry or requirements of the Philippine National Bank, SSS
Diliman Branch, and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 20 th day of
October 2004 in Quezon City, Philippines.
YOLANDA C. PLAMO
Affiant
SUSBCRIBED AND SWORN to before me this 20 th day October 2004 at Quezon
City, affiant exhibited to me her Res. Cert. No. _______________ issued on
_________________ at __________________.

Doc. No. ________;

Page No. ________ ;
Book No. ________ ;
Series of 2004.

JOSE C. SALVADOR
Notary Public
Until December 31, 2004
PTR No. A-49901400 01/05/04 Q.C.

REPUBLIC OF THE PHILIPPINES

QUEZON CITY, METRO MANILA

)
) S.S.

AFFIDAVIT OF WARRANTY
ENGINE ONLY
I, JOSE ALLEN BERCES, represented by JOSELYN DELGADO, of legal age,
Filipino and a resident of 79-C Kitanlad St., Quezon City, after having been duly
sworn to in accordance with law, hereby depose and say:
5.

That I am the lawful owner of that certain motor vehicle engine which is
more particularly described as follows:
Toyota Diesel Engine with Engine No. 2C-0964961

6.

That the above-described engine had never been registered with the LTO
and is only for this very instance that the same be registered;

7.

That I hereby give warranty and absolved the personnel of the LTO and so
with its officials of any future liabilities/responsibilities arising out of this
warranty;

8.

That I guarantee that the same is free from any liens and encumbrances
whatsoever.