Republic of the Philippines )

Province of Zamboanga Sibugay ) s.s

AFFIDAVIT OF UNDERTAKING

I, EDWIN GUILLERMO AYOMA, married, Filipino, with postal address at Purok

Matinabangon, Kauswagan, Diplahan, Zamboanga Sibugay after having been sworn in
accordance with the law hereby depose and say:

1. I am the owner of a vehicle which figured in an accident on November 06, 2018 at

Poblacion, Diplahan, Zamboanga Sibugay as reflected in the records of Diplahan
Municipal Police Station;

2. Said vehicle is described as follows:

Make : Foton
Type :SUV
Chassis No. : LVCP2GBA7GJ023690
Engine No. : ISF28S4161P89716614

3. That I will be allowed to take provisional custody of the above-described vehicle

without prejudice to the final outcome of the case;

4. I hereby undertake to produce said vehicle upon request of the authorities if such
will be needed for further proceedings or investigation.

5. That I will ensure the regular maintenance check-up of the deterioration at my

own expense.

6. I am executing this undertaking to attest to the truth of the foregoing.

IN WITNESS WHEREFOR, I have hereunto set my hand this __________ day of

November 2018 in Diplahan, Zamboanga Sibugay.

EDWIN GUILLERMO AYOMA

SUBSCRIBED AND SWORN to before me this _________ day of November 2018 in

__________________________________. Affiant exhibiting to me his PRC ID No. 41320
expiring on February 7, 2019.

Doc No. ______

Page No. _____
Book No. _______
Series of 2018