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Republic of the Philippines)

In the City of Pagadian ) S.S.

AFFIDAVIT OF CHANGE COLOR


OF MOTOR VEHICLE

I, _____________________, Filipino of legal age, married and a resident of R.T.


Lim Street, Sto. Niño District, Pagadian City, after having been duly sworn to an oath in
accordance with law, do hereby depose and say that:

1. On 1 September 2006, I bought a motor vehicle from one,


_______________________, particularly described as follows:

Make/type ---------------------Suzuki/3 Dr. Sedan


Motor # -------------------------1152159
Chassis # ------------------------CN-225251077
Plate # ---------------------------MBL – 728
Certificate of Reg. # ----------41726057
Official Receipt # ------------- 6158312-6

2. The original color of said motor vehicle was white. Recently I decided to
change the color of said motor vehicle to “formula red”;

3. For purposes of repainting the same, I hired the services of


____________________ a resident of Tuburan District, Pagadian City, whose signature
appears herein-below;

4. I am executing this affidavit to attest to the truthfulness and veracity of my


declarations and for whatever legal purpose this may serve;

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my


signature this 5th day of September 2006 at Pagadian City, Philippines.

___________________________
Affiant

________________________________
Painter

SUBSCRIBED AND SWORN to before me this 5th day of September 2006 at


Pagadian City, Philippines.

CERTIFICATION

I HEREBY CERTIFY that I have personally examined the herein affiant who
caused the preparation of the foregoing affidavit and I am fully satisfied that he has read
and understood the contents thereof.

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