Republic of the Philippines )

City of Iligan ) S.S.

AFFIDAVIT OF UNDERTAKING

I, Emmanuel A. Lacida, of legal age, single and a resident of P6, Brgy. Poblacion, Linamon, Lanao
del Norte, after having been sworn to an oath in accordance with law, hereby depose and state:

1. That I am the registered owner of one (1) HONDA GENIO red/white with Plate No. 1017-
809841 with chassis no. JF93E700742 covered by Certificate of Registration (C.R.) and
Official Receipt (O.R.) both updated and issued by the Land Transportation Office, Iligan
City Field Office;

2. That sometime on May 30, 2021 at around 5:50 in the afternoon, more or less, I drove the
above-described motorcycle with my neice Nicole Jane L. Cabalhin, as my backride, along
the National highway, near LANECO – Linamon Branch when I met a vehicular accident
involving one (1) Suzuki rider motorcycle driven by a certain SAIDAMEN C. SAUMAY;

3. That as a result of the said incident, me and my niece sustained injuries leading us to
immediate treatment at Gregorio T. Lluch Memorial Hospital while the other party was
brought to Adventist Medical Center, Tibanga, Iligan City;

4. That the incident resulted to my HONDIA GENIO being damaged and is presently being
impounded at Municipal Police Station – Linamon Lanao del Norte which may be exposed
to all weather condition that would lead to the deterioration of the said motorcycle to my
prejudice;

5. That I am requesting the Police authority of the said place to release my vehicle so I could
repair the damage it sustained with the undertaking that should there be further
investigation to be conducted before any Prosecutors’ Office and/or the Courts, I am willing
to surrender the same to give way to the investigation;

6. That I am executing this affidavit to attest to the truth and veracity of the foregoing facts of
my own personal knowledge and belief and to support for the release of the said motocycle
to my custody from the Municipal Police Station – Linamon Lanao del Norte, being its
lawful and registered owner.

IN WITNESS WHEREOF, I have hereunto set my hand this _________ day of ____________, 2021
at the City of Iligan, Philippines.

EMMANUEL AGAWIN LACIDA

Affiant

SUBSCRIBED AND SWORN to before me this __________ day of _______________, 2021 at the
City of Iligan, Philippines. Affiant exhibited to me his Government Identification card with his photo and
signature affixed therewith.

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