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Republic of the Philippines )

City of Butuan ) S.S.

AFFIDAVIT OF UNDERTAKING

I, ERICVEN ROBLES CHAVEZ, Filipino, of legal age, single, a

resident of P-49 JPMI Subd., Luho River., Davao City, a driver, under
oath, hereby declare that:

1. I am the assigned driver of a Portland Dump Truck with Plate

No. AAO 6950 registered under the name of DJLH Builder’s
Corporation.

2. Yesterday, 29 March 2017, at about 8:00 in the morning, while

I was driving the aforementioned truck going from Barangay
Bit-os going to the city proper, I accidentally met a head – on
collision with a racer bike driven by Eddie Barbante Gabaisen.
The said bike swerved to the opposite lane, the road right of
way of the truck I was driving, which is why I accidentally ran
over him. He was later died after suffering serious injuries.
Negotiations have been made with the concerned parties.

3. I undertake to present the above-mentioned vehicle anytime

whenever ordered by any court or agency for further
investigation, and to shoulder the necessary expenses for
repairs.

Voluntarily done this _______________, at Butuan City.

ERICVEN ROBLES CHAVEZ

I.D. Name: _____________________
I.D. No. ______________________

SUBSCRIBED AND SWORN TO BEFORE me this _____ day

of _________________, affiant exhibiting to me his government issued
I.D. Card with his picture and signature appearing thereon.

Doc. No.________
Page No.________
Book No._______
Series of 2017.
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Republic of the Philippines )

City of Butuan ) S.S.

AFFIDAVIT OF UNDERTAKING

I, GILBERT I. BANBAN-EG, Filipino, of legal age, single, a

resident of Barangay Sto. Nino, RTR, Agusan del Norte, a driver, under
oath, hereby declare:

1. I am the assigned driver of a van with Plate No. LYF 811

registered in the name of Meriam B. Pajo.

2. Today, 13 October 2016, at about 6:00 in the evening, while

I was driving along Maharlika Highway, Barangay Taguibo, Butuan City. I
was accidentally bumped by a motorcycle driven by JEFRY JAIME who
later died after suffering serious injuries. Negotiations have been made
with the concerned parties.

3. I undertake to present the above-mentioned vehicle anytime

whenever ordered by any court or agency for further investigation, and to
shoulder the necessary expenses for repairs.

Voluntarily done this _______________, at Butuan City.

GILBERT I. BANBAN-EG
I.D. Name: _____________________
I.D. No. ______________________

SUBSCRIBED AND SWORN TO BEFORE me this _____ day

of _________________, affiant exhibiting to me his government issued
I.D. Card with his picture and signature appearing thereon.

Doc. No.________
Page No.________
Book No._______
Series of 2016.
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