REPUBLIC OF THE PHILIPPINES)

CITY OF COTABATO ) S.S.

x------------------------------------x

AFFIDAVIT OF CHANGE COLOR

I, ___________________, of legal age, Filipino, (single/married/widow)

and a resident of _______________________________, after having been
duly sworn to in accordance with law, depose and state THAT:

1. I am the registered owner of a motor vehicle which is particularly described as

follows:

Make & Type : ______________

Motor Number : ______________
Chassis Number : ____________
Plate Number : ______________
MV File No. : ________________
Year Model :_________________
Color : _____________________

2. The original color of the said motor vehicle was "_____________";

3. 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. Said change of color is not intended for any illegal or unlawful purpose but
solely due to the foregoing reasons;

5. 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 have hereunto set my hand

this ___________________ in Pasay City, Metro Manila, Philippines.

____________________
Affiant

SUBCRIBED AND SWORN TO before me this ___________________ in

_________________, Philippines, affiant exhibiting to me his/her competent
evidence of identity by way of __________________ issued at
______________ on __________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2024.