REPUBLIC OF THE PHILIPPINES 

)
QUEZON CITY, METRO MANILA ) S.S.

AFFIDAVIT OF UNDERTAKING

I, ______________________ of legal age, married and a resident of 26 Verbena St.,

Rivera Village, Pasay City after having been duly sworn on oath in accordance with law,
do hereby depose and say:

1. That I am an employee of the Quezon City Hall having been

appointed/designated as Local Legislative Staff Officer IV;

2. That I was appointed from July 1, 2013 to July 2015;

3. That I am securing a Terminal Leave from the said Office;

4. That I promise to comply with the requirements of the Fiscal Management

Division, regarding the Audit of my financial transactions as accountable officer
immediately after my return;

5. That in case of failure to comply with the requirements, I am giving authority to

the Chief of the Financial Management Office to with hold my salaries and other
allowances effective ________________.

IN TRUTH WHEREOF, I have hereunto signed my name below this 18TH day of
JULY, 2016 at Quezon City, Philippines. 

__________________________
Affiant

SUBSCRIBED AND SWORN TO before me this ____________ day

of ________________ 20____ affiant exhibiting to me his/her CTC # _____________
_______ issued at ________________ on _________________.

NOTARY PUBLIC

Doc. No. : _______

Page No. : _______
Book No. : _______
Series of 2016