REPUBLIC OF THE PHILIPPINES )

City of _____________________) s.s.

x-----------------------------------------------x

AFFIDAVIT OF CHANGE OF COLOR OF MOTOR VEHICLE

I, ___________________________________________, of legal age, Filipino, single and a resident of
____________________________________________________________________________________,
after having been duly sworn in accordance to law, depose and state that:

1. I am the owner and operator of ___________________________________________;

2. There is a motor vehicle more particularly described as follows:

Make and Type :

Engine Number :
Chassis Number :
Plate Number :
MV File Number :
Year Model :
Color :

3. The original color of the motor vehicle was registered as “Polished Metal”;

4. When the paint of the above-described motor vehicle had faded , I had its color repainted to
“Black” such that the color of the said motor vehicle was changed from “POLISHED METAL” to
“BLACK” as per request of the owner of said motor vehicle;

5. Said change of color is not intended for any illegal or unlawful purpose but solely due to the
foregoing reason;

6. I am executing this affidavit to attest to the truth of the foregoing and in support of the
registered owner’s application for the change of color of the above-mentioned motor vehicle
on its Certificate of Registration;

IN WITNESS WHEREOF, I have hereunto set my hand this ________ of (month), 2019 in ______City,
Metro Manila, Philippines.

________________________________
(ID no.)

SUBSCRIBED AND SWORN TO before me this __________ in ____________________,

Philippines, affiant exhibiting to me his/her competent evidence of identity by way of
__________________________ issued at _______________ on _________________________.

Notary Public

Doc No. :__________;

Page No. :__________;
Book No.:__________;
Series of 2019.