REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BENGUET ) SS.

CITY OF BAGUIO )

AFFIDAVIT OF CHANGE COLOR

I, LEOPOLDO E. CARIG SR., of legal age, married, Filipino and

with residence at #119 SLU-SVP, Bakakeng, Baguio City, under oath, depose
and say that:

I am an owner of a Motor Vehicle which is particularly described

as follows:

MAKE MITSUBISHI-FUSO
TYPE JITNEY
MOTOR NO 4DHA-705021
SERIAL/CHASSIS NO STM-200310692-C
PLATE NO AHE796
MV FILE NO 1404-15318
CR NO 3845641-2

I had personally caused the change of the color of the above-

described motor vehicle from GALVANIZE to STAINLESS and BLACK
(STAINLESS at the front and back and BLACK the rest of the body) at the
repair shop;

That I am executing this affidavit attest to the truth of my

foregoing statements and to comply with the rules and regulations of the
Land Transportation Office anent the change of COLOR of a motor vehicle.

IN WITNESS WHEREOF, I have hereunto affixed my name and

signature this 26th day of May, 2017, at Baguio City, Philippines.

LEOPOLDO E. CARIG SR.

Affiant
Senior Citizen ID No. 07050
Issued On: 12-06-07
Issued At: Baguio City

SUBSCRIBED AND SWORN TO BEFORE ME, this 26th day of

May, 2017, at Baguio City, Philippines. Affiant personally appeared before me
and identified by me through his Senior Citizen ID and to be the same person
who executed this instrument.

MODESTO T. ANDONG
Notary Public
Commission No. 35-NC-16-R/Until: December 31, 2017
PTR No. 2945281/01-05-2017/Baguio City
IBP No. 1056844/01-05-2017/Baguio-Benguet Chapter
 Roll No. 31289/5-15-81/Manila
Doc. No. 191; MCLE COMPLIANCE No. VI-0000192/June 14, 2016
Page No. 39; BIR TIN No. 121-017-652
Book No. XXIII; No. 19, 2nd Floor Old Market Bldg.,
Series of 2017. Magsaysay Ave., Baguio City, Philippines