Republic of the Philippines }

City of Baguio } s.s.

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

AFFIDAVIT OF CHANGE COLOR

I, _________________, of legal age, Filipino, single, and a resident of

_______________________________, after having been duly sworn to in accordance
with law, depose and state that:

1. I am the registered owner of a motor vehicle which is particularly described as follows:

    
             Make & Type :  ______________
             Motor Number : ______________
             Chassis Number : ____________
             Plate Number : ______________
             MV File No. : ________________
             Year Model :_________________
         Color : _____________________

2. The original color of the said motor vehicle was "_____________";

3. When the paint of the above-described motor vehicle had faded, I had its color

repainted to "_________" such that the color of the said motor vehicle was changed from
"_________" to "________";

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

5. I am executing this affidavit to attest to the truth of the foregoing and in support of the
application for the change of color of the above-described motor vehicle on its Certificate
of Registration.

IN WITNESS WHEREOF, I have hereunto set my hand this 24th day of

September in Baguio City.

___________________________
Name
Affiant
SSS ID No. _____________

SUBCRIBED AND SWORN TO before me this 24th day of September in the

City of Baguio, Philippines, affiant exhibiting to me his competent evidence of identity
by way of __________________ issued at ______________ on __________________.

Notary

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.