REPUBLIC OF THE PHILIPPINES

AFFIDAVIT OF CHANGE
MOTOR/CHASSIS/COLOR/BODY DESIGN/DENOMINATION

I, ________________________________________, Filipino, of legal age, and residing at

_______________________________________________, after having been duly sworn to in accordance
with law do hereby depose and say;
That I am the true and lawful owner of a motor vehicle/motorcycle which is more particularly
described as follows to wit;

MAKE AND TYPE :

MOTOR NUMBER :
CHASSIS NUMBER :
M.V. FILE NO. :
PLATE NUMBER :

That I change of __________________________________________________________ from

_____________________________ to __________________________________;
That the change was done at the local body builder shop under my supervision and was finished
only today;
That I am executing this affidavit to attest to the truth of the above mentioned and to report and
register the said change.
IN WITNESS WHEREOF, I have here unto set my hand this __________ day of ______________,
______________.

____________________________
AFFIANT

SUBSCRIBED AND SWORN to before me a Notary Public, for and in the City of ______________,
Metro Manila, Philippines, affiant exhibited to me his/her Com. Tax. Cert. No. _____________________,
issued on ________________ at _____________________.

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