REPUBLIC OF THE PHILIPPINES)

DONE: IN THE CITY OF BAGUIO) SS

X ------------------------------------------X

AFFIDAVIT
I /WE MARILYN P.CHUPENGNA and KILAAN,JACKSON , of legal age, Filipino
citizen, and a resident of AD259 Buyagan, La Trinidad, Benguet, after having been duly sworn to in
accordance with law, depose and say:

1.That I /We am the owner of a motor vehicle more particularly described as follows:

MAKE . . . MITS/ PAJERO

MOTOR NO.. . . 4D56-FG9725
CHASSISS NO. . . . V44-4051841
PLATE NO. . . . RAV 797

2. That I personally contacted a private mechanic/painter to cause the change of color of the above
described motor vehicle from NOT INDICATED to NATURE BLUE;

3. That I executing this affidavit to attest to the truth of the foregoing statements particularly to
request the concerned government office to cause the correction of the records as well as the entry in
the Certificate of Registration of the above motor vehicle in order to reflect the current color thereof as
disclosed above, and for all legal intents and purposes this instrument may well serve.

AFFIANT FURTHER SAYETH NAUGHT.

KILAAN JACKSON MARILY N P. CHUPENGNA

Affiant /Painter Affiant /Owner

SUBSCRIBED AND SWORN to before me this 12th day of July 2017 in Baguio City,
Philippines. Affiant presenting competent proof of identification indicated under her typewritten name.

Doc. No. ___, Page No. ____

Book No. ___, Series of 2017.