REPUBLIC OF THE PHILIPPINES )

PROVINCE OF RIZAL )
MUNICIPALITY OF _______________ )

AFFIDAVIT OF UNDERTAKING

I, JACK S. STA. RITA, of legal age, Filipino, married and residing at No. 8001
Roxas Road, Brgy. May-Iba, Teresa, Rizal, after being duly sworn to in accordance with
law, here by depose and state: That

1. I represent the FIRST PHILIPPINE TERESA RUBBER (FPTR) Corporation

with business address at Roman Roxas Road, May-Iba, Teresa, Rizal.

2. I am process of securing Certificate of Occupancy Permit for the Proposed

Warehouse we built at Roman Roxas Road, May-Iba, Teresa, Rizal.

3. One of the deficiencies noted by the Inspector from the Municipal Engineering
Office of Teresa, Rizal was the door located at the back, which according to
them is not included in the approved plan.

4. As the said door is suppose to be used by some of the employees of FPTR,

thus, will pass through the lot of South Pacific, a lot adjacent to the lot FPTR,
FPTR intend to purchase of portion of land owned by South Pacific, and there
is an on-going negotiation relative thereto.

5. I hereby absolutely, remise, release and forever discharge the Municipality of

Teresa, Rizal, its officers, Engineering Office of Teresa, Rizal, administrators
and assigns and/or any of its officers or employees from any and all claims,
suits, actions or causes of action which our successors now have or in the
future may be against said government agency, and I hereby further obligate
myself solely to indemnify the said government agency, its administrator and
assign, and/or its officers or employees for liabilities that may arise.

6. My above declarations were made in good faith and I have no intention to

commit any fraudulent act or purpose.

7. I am executing this Affidavit to attest to the truth of the foregoing facts and for
whatever legal this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12 th day of

May 2023 at Teresa, Rizal.

JACK S. STA. RITA

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of May 2023 at

___________. Affiant exhibited to me his government issued identification card Driver’s
License No. N03-17-018691 as competent evidence of his identity.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2023.