I, _____________, Filipino, of legal age, (single / married / widow), and a resident of _____________,

Philippines, after being sworn to in accordance with law, depose and state:
1.That I am the registered owner of a certain motor vehicle that is more particularly described as follows:
Make: Motor No.:
Type: Chassis No.:
Series: Plate No.:
2. That my above said motor vehicle bears YELLOW PLATE as it was intended as “for hire” as public
utility vehicle;
3. That I now intend to change the use of my vehicle from “for hire”/ public utility purpose to a private
use only or GREEN PLATE;
4. That the change of use and plate color of the above vehicle is not intended for any illegal or unlawful
purpose but solely due to the foregoing reasons;
5. That I am executing this Affidavit to attest to the truth of the foregoing and in support of the
application for the change of plate number color and purpose of the above-described motor vehicle on its
Certificate of Registration.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ in _____________,

Philippines.