Republic of the Philippines}

City of Lapu-Lapu. }S.s.

AFFIDAVIT
With Undertaking

I, JIUFEL B. ABESTANO, of legal age, Filipino, and a resident of Brgy. Gun-ob

Lapulapu City, under oath, hereby state that:

1. I am the authorized driver of a motor vehicle KIA FORTE SEDAN (white) with
plate no. GDN 2690 which figured an accident last March 1, 2023, at 1:40 PM, in
front of M-OIL Gasoline Station, Mactan Circumferential Road, Brgy.
Marigondon, LLC., with License Number JO1-16-002408.
2. Because of such incident, my driver’s license has been confiscated by PSSg Allan
Osabel, an officer of the Lapu-lapu City Police Office, Police Station 4.
3. I hereby undertake to produce my driver’s license upon request of LTO
authorities if such will be needed for further proceedings or investigation.
4. I am executing this affidavit to attest to the truth of the foregoing statements and
to support my request for the release of my driver’s license, and for whatever
legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this September 6, 2022 at Lapu-

Lapu City, Philippines.

JIUFEL B. ABESTANO
PAG-IBIG MID NO 1212-5562-3195
Expiring on ____________

SUBSCRIBED AND SWORN TO before me this March 3, 2023 at Lapu-Lapu City,

Philippines.

Doc. No.
Page No.
Book No.
Series of 2023.