CERTIFICATE OF UNDERTAKING

I, _________________, undertake that in the instance that the Appeal on the Notice of
Disallowance/ Suspension ____________________________in the amount of Php _________
was not granted and it has become final and executory, I shall return the said amount to the
Bureau of Fisheries and Aquatic Resources.

____________________
Affiant

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

_____________________________) S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, personally appeared the
following:
NAME I.D. NO. DATE/PLACE ISSUED

known to me to be the same person who executed the foregoing instrument and acknowledged to me that
the same is their own free will and voluntary act and deed.

This instrument consists of one (1) page wherein this Acknowledgement is written, and is signed
by the party on this page hereof.

WITNESS MY HAND AND SEAL, this _____ day of ______ 2020 at __________, Philippines.

________________________
Notary Public
Doc. No. _______
Page No. _______
Book No._______
Series of 2020