You are on page 1of 1

REPUBLIC OF THE PHILIPPINES) MANILA ) S.S. AFFIDAVIT OF CHANGE OF COLOR I, LUIS P.

JOSE, of legal age, Filipino with home address at 575-C Atty. Mendoza St., Bgy. Pedro Cruz, San Juan City, after having duly sworn to in accordance with law, hereby depose and state that: 1. I am the buyer of One (1) Unit 1992 4-door Sedan Silver Honda Civic with Chassis No. SR3-920124 and with Engine No. PH12-0000238 with PLATE NO. TDX-699 to the former owner, Mr. MONCERTH CAROLINO CARACAS; I bought the said motor vehicle on October 1, 2012 to Mr. Moncerth Carolino Caracas; The said motor vehicle has changed its color from SILVER to WHITE; I am executing this Affidavit to attest to the truth of all the foregoing facts.

2. 3. 4.

AFFIANT SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto set my hand this 22 nd day of October 2012. LUIS P. JOSE Affiant

SUBSCRIBED AND SWORN TO before me this 22nd day of October 2012 at Manila. Notary Public

Doc. No. Page No. Book No. Series of 2012.

You might also like