Republic of the Philippines )

City of ________________) S.S.

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

I, BALAGBIS, EDMON JARDIO, of legal age, single/married, Filipino, and a

resident of 804 2A Palmdale Height, Sandoval Avenue, Brgy. Pinagbuhatan, 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 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 1 st day of

February 2024 in Pasig City.

___________________
AFFIANT

SUBSCRIBED AND SWORN TO before me this ______ day of

_______________, 2024 at ________________________________________,
affiant having exhibited to me his Driver’s License No. NO1-19-058175 issued on 19
November 2019.

Doc No.: __________

Page No.: __________
Book No.: __________
Series of 2024