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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAPIZ ) S.S.


MUNICIPALITY OF MAMBUSAO )
X--------------------------X

AFFIDAVIT OF UNDERTAKING

I, JOSE JOELY AZUNADA MALONES, of legal age, married, Filipino, and a


resident of Brgy. Bunga, Mambusao, Capiz, after having been duly sworn to in
accordance with the law, hereby depose and state that:

1. I am the authorized driver of a passenger bus owned by ALPS THE BUS INC.
with plate number TYU140, motor number DE12TIS904308BA, and chassis
number PL5UN58JD9K290025;

2. That sometime on 5 February 2023, approximately about 11:30 in the


morning, I was a party to an accident whereby I accidentally bumped into the
right side of the back portion of the Isuzu MU-X SUV Wagon, with plate
number FAE5681, engine number RZ4ESK6593, and chassis number
MPAUCR87GJT001408, driven by EDWIN ALAYON ADO together with his
wife JOSEPHINE LISAMOS ADO;

3. Because of the accident, the vehicle of EDWIN ALAYON ADO sustained


damages and needs to be repaired;

4. Thus, I own responsibility to EDWIN ALAYON ADO and his wife JOSEPHINE
LISAMOS ADO for damaged sustained by their vehicle and I undertake to
assure that I will shoulder and satisfy any and all expenditures relating to the
repair of the Isuzu MU-X SUV Wagon;

5. I am executing this Undertaking after serious thought, without any fraud,


force, intimidation, or violence applied to me to vitiate my consent and with full
knowledge of my rights under the law.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


___________ at Mambusao, Capiz, Philippines.

JOSE JOELY AZUNADA MALONES


Affiant
Driver’s License No. F03-96-097909

SUBSCRIBED AND SWORN to before me this ____________________ at


Mambusao, Capiz, Philippines, by the affiant who personally appeared to me and
exhibited to me his/her Driver’s license indicated below his/her name and signature,
known to me to be the same person who executed the foregoing Affidavit of
Undertaking.

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