REPUBLIC OF THE PHILIPPPINES)

CITY OF BAGUIO )S.S.

AFFIDAVIT

I, YOLANDA L. BASTIAN , of legal age, Filipino, married, with

residence at Caponga (Pob) Tublay Benguet, Philippines after having
been duly sworn to in accordance with law, hereby depose and state
that:

1. That I am the present possessor of a certain motor vehicle

that is more particularly described as follows:

Make: Toyota Engine No.: 7K-0732423

Type: WAGON Chassis No.: KF82-6008388
Color: Glacia Plate No.: XPJ928

2. That the original color of the said motor vehicle was

“Glacia” ;

3. The color of the said motor vehicle is now “Two-toned,

Glacia and gray”, Glacia as the main color;

4. That said change of color 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
color of the above-described motor vehicle on its Certificate of
Registration.

IN WITNESS WHEREOF, I hereunto set my hand and sign this

Affidavit this 9th day of August, 2022, in Baguio City, Philippines.

YOLANDA L. BASTIAN
Affiant

SUBSCRIBED AND SWORN TO before me this 22 th day of August,

2022 at Baguio City, Philippines by the Affiant who personally appeared
before me and I am satisfied that she is the same person who executed
the foregoing affidavit.