Republic of the Philippines )

City of ________________) S. S.

AFFIDAVIT OF UNDERTAKING
(FOR 10 YEAR VALIDITY PERIOD OF LTOPF)

I, ___________________________, of legal age, single/married, Filipino, and

a resident of _____________________________________, after having been sworn
in accordance with law, do hereby depose and say, THAT:

1. I am an applicant for License to Own and Possess Firearms (LTOPF) and

opted to avail ten years validity period of my LTOPF.

2. Having opted to have a 10-year LTOPF validity period, I shall undertake to

submit Neuro-Psychiatric Clearance and Drug Test Result when required
by the CPNP or his authorized representative as part of monitoring my
fitness to own and possess firearm;

3. In case there is a failure or refusal on my part to submit my Neuro-

Psychiatric Clearance and Drug Test Result, when required, my LTOPF
and that of the firearm registration shall be suspended immediately without
prior notice and the firearm/s shall be confiscated;

4. I am executing this affidavit to attest to the truthfulness of the foregoing

and for all legal intents and purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this ______ day of

_________ 2022 at ___________________________.

______________________
AFFIANT
SUBSCRIBED AND SWORN TO before me this ________ day of
_______________, 2022 at ____________________________________________,
affiant having exhibited to me his/her ID Card Number __________________ issued
on _________________________________ and with Expiration Date of
_______________________________.

Doc No: __________

Page No: _________
Book No: _________
Series of 2022

_________________________ RIGHT THUMBMARK

NOTARY PUBLIC (Roll thumbprint from left to right)

FEO LTOPF Form Series of 2019