REPUBLIC OF THE PHILIPPINES)

CITY OF BAGUIO…………………….)

AFFIDAVIT of CHANGE COLOR

(Re: ADDITIONAL COLOR)
I, ELEUTERIO N. CAMTUGAN Jr., of legal age, married, Filipino and
with residence at Upper Pias, Camp 7, Baguio City, Philippines, after having
been duly sworn to in accordance with law hereby deposes and states that:

1. I am an owner of a certain motorcycle without sidecar with Plate

Number – AU28969, Chassis Number – MD2A12DZ6FCL88262
and Engine Number – DJZCFL04678, and under Certificate of
Registration No. 280937646;

2. The color of the said motorcycle is RED as indicated in all its

documentations, however, the color of its tank and part of the front
is BLACK, thus, it has a combination of RED/BLACK;

3. I now request the Land Transportation Office (LTO) to cause the

necessary amendment of the registration and other
documentations of my above-described motorcycle to reflect its
true color which is RED/BLACK;

4. I am executing this affidavit attest to the truth of my foregoing

statements and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my name and signature

this 2 day of July, 2021, at Baguio City, Philippines.
ND

ELEUTERIO N. CAMTUGAN Jr.

AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME, this 22nd day of

September, 2021 at Baguio City, Philippines, affiant personally came to me and
personally known to me to be the same person who executed this instrument.

MODESTO T. ANDONG
Notary Public
Commission No. 35-NC-20-R/Until: Dec. 31, 2021
PTR No. 4867667/12-22-2020/Baguio City (for 2021)
IBP Prov. No. 006630/12-22-2020 (for 2021)
Roll No. 31289/5-15-81/Manila
Doc. No. 310; MCLE COMPLIANCE No. VI-0000192/June 14, 2016
Page No. 62; BIR TIN No. 121-017-652
Book No. 50; No. 19, 2nd Floor Old Market Bldg.,
Series of 2021. Magsaysay Ave., Baguio City, Philippines