REPUBLIC OF THE PHILIPPINES)

DONE: IN THE CITY OF BAGUIO) SS

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

AFFIDAVIT
I, WEDION C. BANTILOC, of legal age, Filipino citizen, and a resident of Sagpat ,Kibungan
Benguet, after having been duly sworn to in accordance with law, depose and say:

1.That I am the owner through deed of sale of a motor vehicle more particularly described as follows:

MAKE . . . TOYOTA
MOTOR NO.. . . 2C 2963075
CHASSISS NO. . . . CF5000137
PLATE NO. . . . UAC 356

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 WHITE;

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.

WEDION C. BANTILOC
Affiant

SUBSCRIBED AND SWORN to before me this 11 th 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;.