Republika ng Pilipinas)

Binangonan, Rizal) Sc.

AFFIDAVIT OF UNDERTAKING

I, ______________________________________, of legal age, Filipino

citizen and a resident of _______________________________________,
__________________________, ______________, after having been sworn in
accordance with law, hereby depose and state:’’

1. I am an elected Barangay Kagawad of Brgy.

_________________________________, ___________________, _______________;

2. I personally know ________________________________ as

he/she is a residence of the barangay where I am serving as a Barangay
Kagawad;

3. He/she was convicted for violation of R.A. No. 9165 by the

Binangonan, Rizal, RTC – Branch __ with Criminal Case No.
______________________________________;

4. I have learned that he/she was sentenced to suffer a penalty

of imprisonment and that he/she is applying for probation;

5. I undertake to be his/her custodian during the probation

period. I fully understand the duties and responsibilities of this
undertaking which includes presentation of the person of the accused to
this Honorable Court or other lawful authorities whenever his/her
presence is so required; and

6. I voluntarily executed this Affidavit for all legal purposes this

may serve.

IN WITNESS HEREOF, I hereby affixed my signature this ___ day of

__________________ 2020 in _____________________, __________, Philippines.

_______________________________
Affiant
(Signature over printed name)

SUBSCRIBED AND SWORN to before me this ___ day of

__________________ 2020 in ___________________, ___________, Philippines.

Doc. No. ___;

Page No. ___;
Book No. ___; ____________________
Series of 2020. Notary Public