REPUBLIC OF THE PHILIPPINES)

CITY OF BAGUIO…………………….)

AFFIDAVIT of ADDITIONAL COLOR

I, EVA DUPA SOLIMEN, of legal age, ,married, Filipino and with
residence at 113 Prk. 4, Gabriela Silang, 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 motor vehicle with Plate Number –

WHR896, Chassis Number – SXA11-0222298 and Engine Number
– 3S-2652450, which I acquired by virtue of a Deed of Sale and yet
to be transferred in my name;

2. The color of the said vehicle is GREEN as indicated in all its

documentations, however, in the lower portion its color is GRAY,
thus, it has a combination of GREEN/GRAY;

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

necessary amendment of the registration and other
documentations of my above-described motor vehicle to reflect its
true color of GREEN /GRAY;

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 4 day of June, 2021, at Baguio City, Philippines.
th

EVA DUPA SOLIMEN

AFFIANT
UMID CRN-0111-0050966-2

SUBSCRIBED AND SWORN TO BEFORE ME, this 4th day of June, 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. 329; MCLE COMPLIANCE No. VI-0000192/June 14, 2016
Page No. 66; BIR TIN No. 121-017-652
Book No. 48; No. 19, 2nd Floor Old Market Bldg.,
Series of 2021. Magsaysay Ave., Baguio City, Philippines