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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF ) S.c.
MUNICIPALITY OF )

AFFIDAVIT OF UNDERTAKING

I, _________________, ____ years old, married, Filipino, and


resident of ____________, after having been sworn to in accordance with
law, do hereby deposes and states:

1. That I am the owner of the subject motor vehicle, Red Suzuki


Smash Motorcycle, with Engine No. ______, Chassis No. ___
under Certificate of Registration No. _____, and Official Receipt
No. ______;

2. That subject motor vehicle was confiscated by the PNP ______ on


______ at ______, in connection with Criminal Case No. ______
for “___________”;

3. That I hereby undertake to produce said vehicle upon request of


the authorities if such will be needed for further proceedings or
investigation;

4. I am executing this undertaking to attest to the truth of the


foregoing and to support my request for the release of the
impounded vehicle.

IN WITNESS WHEREOF, We have hereunto set our hands this 28th


day of February, 2019 at _____________.

Affiant

SUBSCRIBED AND SWORN TO before me this 28th day of February


2019 at. Affiants exhibited to me his _____ issued at _______.

NOTARY PUBLIC

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