REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO ) S.S.

x---------------------------------------x

AFFIDAVIT OF UNDERTAKING

I,___________________________ ,______________ Filipino, single, and presently residing

(Name of Student), (Age)
at
______________________________________________________________________________
(address of student),
after having been duly sworn to in accordance with law, depose and state:

1. That I am a duly enrolled student of West Visayas State University – Main Campus (La
Paz, Iloilo City), with Student Identification Card Number: _______________;

2. That I acknowledge having received, ON LOAN (commodatum),

Please check the item(s) to be received based on your department
(_____) One (1) Unit Educational Tablet including accessories (College Students)-
Main Campus
(_____) One (1) Unit USB Stick/Flash Drive (ILS/SHS)
from West Visayas State University, Main Campus, particularly described as follows
(including its accessories):
Brand: Lenovo
Model Lenovo M7(ZA570081PH)
Accessories: Power Adapter

3. That I further acknowledge that said Tablet, its accessories, and the learning materials
contained therein, are the sole and exclusive properties of West Visayas State
University;

4. That I shall use said Tablet only for the purpose of accessing my lessons and submitting
requirements for the subjects I have enrolled in, and shall not allow third persons to
use said Tablet and its accessories. Nor shall I share the learning materials contained
therein, to said third persons, unless with prior consent of the University. Otherwise, I
will face the consequences for any unauthorized distribution of said Learning Materials;

5. That I shall take good care of said Tablet during the period that it is in my charge, and
in case of damage or loss of the tablet and its accessories, I shall take full responsibility
for its repair/replacement;

6. That I shall return said Tablet and its accessories at the end of every semester, or earlier,
whenever advised by the University, and in the condition in which it was received by
me;

7. That I shall not make any modification or alteration of any hardware and operating
system (rooting), or any action that will permanently damage the device;

8. That I shall adhere to all University policies regarding the use of said Tablet, and shall
not violate any Digital Copyright Laws; and
9. That I execute this Affidavit willingly and voluntarily and have understood the terms
and conditions set forth therein.

IN WITNESS WHEREOF, I have hereunto set my hand this____day

of ______________ in _______________________, Philippines.

With my conformity: (for students who

are not of legal age yet)

(Signature over printed Name) (Signature over printed Name)

Parent/Guardian Affiant/Student
ID No.: ID No.:

Campus:

College/School:

Course:

Year & Section:

SUBSCRIBED AND SWORN TO before me this ____day of _________ in

_______________, Philippines, Affiant exhibiting to me his/her competent evidence of
identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2020.