Republic of the Philippines )

City of Tagum ) S.S.

Davao del Norte )
x - - - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF UNDERTAKING
I, VANESSA MAR NIEZ JOHNSON, Filipino citizen of legal age, married, and resident of
Purok 5, Estabillo Estate, La Filipina, Davao del Norte, after having been duly sworn to in
accordance with law, depose and state, THAT:

1. I am the same and identical person who is the owner/proprietor of (3R BEACH
RESORT, with business address at ____________________, Tagum City, Davao del
Norte;
2. I am an applicant for the Environmental Compliance Certificate (ECC) from the
Department of Environment and Natural Resource - Environmental Management Bureau
(DENR-EMB), over the above-named establishment;
3. I hereby promise and undertake to submit all the requirements for the issuance of the
ECC over the said establishment and undertakes to comply with the said requirements
within a period of three (3) months;
4. In the event I will be caught violating any city ordinance or laws and if in case of my
failure to comply thereat, I hereby undertake to face the consequences i.e. will never be
granted any Permit by the Local Government Unit to do business anywhere in the
territorial jurisdiction of Tagum City, and even to the extent of imprisonment as
consequence thereof; and
5. I am executing this Affidavit to attest to the truthfulness of the forgoing facts and for
whatever purpose this may serve.

Further affiant sayeth none.

IN WITNESS WHEREOF, I have hereunto set my hand this _______________, in Tagum

City, Davao del Norte, Philippines.

VANESSA MAR NIEZ JOHNSON

AFFIANT/OWNER/PROPRIETOR
TIN ID NO. 940-346-633

SUBSCRIBED AND SWORN TO before me this __________________, in Tagum City,

Davao del Norte, Philippines.

ATTY. LYNDON MELVI C. SUMI-OG

Notary Public
Roll No. 74318
PTR No. 264399 Jan. 04, 2021
IBP No. 15374 Jan. 19, 2021
TIN: 288-886-690-000
Email: lyndonsumiog@gmail.com

Doc. No.
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Book No.
Series of 2021.