Republic of the Philippines)

Butuan City ) S.S.

x- - - - - - - - - - - - - - - - - /

AFFIDAVIT OF UNDERTAKING

I, Brgy. Kagawad ______________, of legal age, married, Filipino

and a resident of ______________________________, Philippines, after
having been duly sworn to oath in accordance with law, do hereby
depose and say:

1. That I am the incumbent Brgy. Kagawad of Barangay

__________________________;

2. That I hereby undertake to take custody of the accused

pending approval of probation, charged for the crime of
R.A. 9165 in Criminal Case No. ________________
pending before RTC Branch ____________________;

3. That I can vouch that the accused is resident of

__________________________________________;

4. That I am not a relative of the accused within the fourth

degree of consanguinity or affinity;

5. That I shall undertake to guarantee the appearance of

the accused whenever his presence is required by this
Honorable Court.

6. That I am executing this affidavit to attest the veracity of

the foregoing circumstances.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th

day of December, 2020 in Butuan City, Philippines.

_________________________
-Affiant-
With my consent:

_____________________________
Accused

SUBSCRIBED AND SWORN TO BEFORE ME this 15 th day of

December, 2020 in Butuan City, Philippines.