ANNEX “A”

Republic of the Philippines )

_____________________________ ) S.S.

AFFIDAVIT OF UNDERTAKING
I, _________________________________________________________, of legal age, Filipino, and a resident of
____________________________________________________, after being duly sworn to, under oath and in
accordance with law, do hereby depose and state that:

1. I am the ________________________________ of ___________________________________________________;

2. I accomplished and signed the Mandatory Disclosure Form (MDF) as authorized by the
Board of Trustees of the above-mentioned corporation;

3. The said MDF was filed through electronic mail on _______________, pursuant to the
Guidelines in the Filing or Submission of the Mandatory Disclosure Form for Non-
Stock Corporations;

4. I undertake to submit the printed and notarized copy of the MDF within five (5) days from
the time the Enforcement and Investor Protection Department requires its submission
through personal or other allowed means of filing.

IN WITNESS WHEREOF, I hereunto affix my signature this ______ day of __________ 20_____, at
_______________________________________.

______________________________________
Affiant

SUBSCRIBED AND SWORN TO before me this __________ day of ____________________, 2020 at

______________________, affiant having exhibited to me her ________________ with nos.
_____________________________.

Doc. No.______
Page No.______
Book No.______
Series of 20___.