Republic of the Philippines ]

City of Tagbilaran ] S.S.

AFFIDAVIT OF UNDERTAKING

I, GENNEFER A. BALDAPAN, Filipino, of legal age, married and presently residing in La Paz,
Carmen, Bohol, after being sworn in accordance with law, hereby depose and say:

1. That I am the vendee of a 2001 Honda motorcycle with Plate No. 7A-3094-B, Motor No.
KB502012-00145E and Serial/Chassis No. KB502-012001145 which is registered with the Land
Transportation Office (LTO) under Cert. of Reg. No. 64126394 in the name of Carlito Bacor;

2. That I acquired ownership over the aforesaid motorcycle through purchase, however, I do not
have a deed of sale at present;

3. That I am now in actual possession of the said motorcycle and I am applying for release of its
original Official Plate with the Land Transportation Office (LTO), Tagbilaran City. I will also be
applying later on for the renewal and transfer of its registration in my name;

4. That at the time I acquired the said motorcycle, the same only has a Temporary Plate because I
was told by the registered owner that he has not yet received the original plate from the LTO;

5. That by virtue of these presents, I hereby undertake to comply with all the requirements of the
LTO – Tagbilaran in connection with my application release of original plate of the said motorcycle and
for the subsequent renewal and transfer of registration in my name, including, but shall not be limited to,
the submission of the requirements of LTO as soon as it is available, as well as the payment of all fees
and charges thereof;

6. That I also hold free and harmless the LTO – Tagbilaran City for causing the release and
issuance of original plate in my favor and the subsequent renewal and transfer of registration in my name
despite the lacking requirements;

7. That I execute this affidavit voluntarily to attest to the truth of the foregoing statements to
support my request with the LTO-Tagbilaran City for the issuance of an original plate number of the said
motorcycle and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this 23 rd day of March 2012 at Tagbilaran
City, Bohol, Philippines.

GENNEFER A. BALDAPAN
Affiant

SUBSCRIBED AND SWORN to before me this March 23, 2012 at Tagbilaran City, Bohol,
Philippines, affiant with her PhilHealth Identification Card with PhilHealth No. 12-025257816-7.