Republic of the Philippines )

Done in Lagawe, Ifugao…. ) S.S.

AFFIDAVIT OF CHANGE OF COLOR

I, ____, of legal age, married, Filipino citizen, and residing at ________,

Ifugao, after being sworn to in accordance with law, depose and state:

1. THAT, I am the buyer of one (1) unit _________ and with Engine No.
___ and Plate No. _____ to the former owner, ____________;

2. THAT, the original color of the motor vehicle was ______;

3. THAT,; when the paint of the above-described motor vehicle had

faded, I had its color repainted to "_____________"such that the color
of the said motor vehicle was changed from "_____________" to
"_____________"

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 Registratio;

IN WITNESS WHEREOF, I hereby set my hand this __ day of January

2019 at Lagawe, Ifugao, Philippines.

JOHN DOE
Affiant
TIN: ___

SUBSCRIBED AND SWORN TO BEFORE ME, this ___ day of

January 2018 at Lagawe, Ifugao, affiant exhibited to me his Tax Identification
Number as stated above below his name, as proof of his identity.

Doc. No. ___

Page No. ___
Book No. ___
Series of 2018