REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ________________}
MUNICIPALITY OF ___________} S.S.

AFFIDAVIT OF CHANGE OF COLOR

I, ___________________, of legal age, Filipino, (single/married/widow) 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 _____ day of ____________
2021 in _____________________, Philippines.

_______________________________
XXXXXXXXXXXXXXXXXX
Affiant
ID No.
Issued on:
Place of Issue:

SUBSCRIBED AND SWORN to before me at_______________________,

Philippines this _____ day of ___________, 2021, affiant exhibiting before me her
Competent Evidence of Identity written below her name and signature, that she is the
same person who personally signed before me the foregoing Affidavit and
acknowledged that she executed the same.