Republic of the Philippines)
Quezon city 8S.
ABEIDAVIT OF UNDERTAKING
|_HERNANI E. BAUTISTA , of legal age, Filipino, and a resident
of_BSL10 MBA ST, PTC SOUTH CARSADANG BAGO 4, MUS CITY after being duly sworn
to, under oath and in accordance with law, do hereby depose and state - that
|. Lam the ownerauthorized representative of a business operating under the name and_ style
of_MCP CENTER & INDUSTRIAL SUPPLY ‘andits PHYSICAL STORE is located
at ___Ba32 PG SAMPAGUITA ST.._ ACM CARSADANG BAGO 2, IMUS CITY (Warehouserhome Office)
2. This undertaking is being executed to certify to the Optical Media Board (OMB) that we are
applying for an ‘OMB license as a
IMPORTER /DEALER (TO BE DELIVERED TO CLIENT FOR THEIR GIVEAWAYS
3. We will be seling the following Optical Media Products / Storage Devices that are
sourced from the following SUPPLIERS:
Shenzhen XinShenaang Technology Co.,Ltd 7
BRAND NAME:
NO BRAND
4, The above-mentioned optical media products / storage devices are
B and the same does
ot contain any counterfeit or pirated intellectual property products including, but not
limited to software applications, operating systems, movies, music, or other copyrightable
products. (Please indicate if the products are brand new, secondhand, or mixed)
5. 1am executing this affidavit for the purpose of securing or renewing an OMB license as
‘a condition precedent for securing the necessary business permits, licenses or
registration from the appropriate authorities.
6. | attest to the truthfulness of the foregoing facts and submit to the jurisdiction of the OMB,
as well as to its designated representative, to determine the veracity of all information and
documentation submitted hereunder.
7. \interpose no objection to the automatic suspension, cancellation or revocation of the
OMB license and subsequent closure of the above-cited business establishment, if
deemed necessary, in case a false or misleading information has been furnished thereof.
IN WITNESS WHEREOF,| hereunto affix my signature
—Seotember__ 2024, in Quezon City, Philippines.
is 19h day of
HERNANIE. BAUTISTA
Affiant
SEP 19
SUBSCRIBED AND SWORN TO before me this
Quezon City, Philippines, _affiant having
hisshenOt MU3-4¢- 279234with signature and
evidence of his identity. 64> wae: vad
Doe
Page Ne.
Book No,
Series of 2021