REPUBLIC OF THE PHILIPPINES)

PROVINCE OF DAVAO DEL SUR )S.S.

MUNICIPALITY OF BANSALAN)
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AFFIDAVIT OF UNDERTAKING

I, _____________________________, of legal age, Filipino,

married/single and a resident of
_____________________________________, Davao del Sur, Philippines,
after having been duly sworn to in accordance with law do hereby
depose and say:
1. That I am the same and identical person who have caused the
execution of this affidavit.

2. That I am an occupant of (National Highway, Barangay Road,

Danger Zone) at Barangay Tubod, Bansalan, Davao del Sur.

3. That I am a recipient of a certain parcel of land of the

Barangay Government of Tubod;

4. That I undertake to demolish and relocate to the above-

mentioned parcel of land awarded to me before or after the
course of Six (6) months upon the awarding of the parcel of
land.

5. That I am not coerced in executing this affidavit, further I have

executed this instrument freely and voluntarily to attest to the
truth and veracity of the foregoing allegations.

IN WITNESS WHEREOF, I have hereunto set my hand this

__________ at Banslan, Davao del Sur Philippines.

______________________________________
Affiant
__________________________________

SUBSCRIBED AND SWORN TO BEFORE me this ___________

at Bansalan Davao del Sur, affiant exhibited to me her valid
identification no. shown above below her name.