Republic of the Philippines )

Province of Negros Oriental) S.S.

Municipality of Sibulan)

AFFIDAVIT OF UNDERTAKING

I, UZZIEL Q. ARMENTON, of legal age, Filipino, married and a resident

of Jimalalud, Negros Oriental, after having been sworn to in accordance with
law, do hereby depose and state that:

1. I am the registered owner of one (1) motor vehicle, which is more

particularly described as follows:

CHASSIS NO.: BE4ES-166621 MAKE: SUZUKI

ENGINE NO.:E472-582262 SERIES: FW110D
MV FILE NO.: 0701-00000743962 BODY TYPE: MOTORCYCLE
YEAR MODEL: 2018

2. That sometime on March 2, 2021, at around 4:30 AM, Roldan

Garsula was driving the above-described motor vehicle somewhere at Diputado
Street, National Highway, Poblacion, Sibulan, Negros Oriental, specifically near
Petron, who figured in an accident;

3. That the said motor vehicle is currently in the possession of the

local police of the Sibulan, Province of Negros Oriental;

4. That I need the use of the above-mentioned motor vehicle for my

personal use;

5. That I hereby undertake to surrender the possession or present the

above-described motor vehicle to any court or government entity upon proper
notice;

6. I am executing this affidavit to attest to the truthfulness and

veracity of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd

day of March 2021 in Sibulan, Negros Oriental, Philippines.

UZZIEL Q. ARMENTON
Affiant

SUBSCRIBED AND SWORN to before me, a Notary Public, on this 3 rd day

of March 2021, for the Municipality of Sibulan and the Province of Negros
Oriental, Philippines, UZZIEL Q. ARMENTON, who exhibited before me her
DSWD Pantawid Pamilyang Pilipino Program ID No. 074612025-0223-00087,
and WHO SIGNED IN MY PRESENCE the foregoing document (Affidavit of
Undertaking), and who avows under PENALTY OF LAW to the whole truth of
the contents of the same.

Doc No. 40;

Page No. 9;
Book No. III;
Series of 2021.