Form U-1

REPUBLIC OF THE PHILIPPINES )

Province of Davao del Sur ) Sc.
Municipality/City of DIGOS
X-------------------X

AFFIDAVIT OF UNDERTAKING
I, ____________________________, of legal age, Filipino, married and resident of
___________________________________________________, after having been duly sworn in accordance
with law hereby depose and say that:
1. I am the same and identical person who cause the execution of this affidavit;

2. I am the lawful owner of that piece of land known as Lot No. ______________, Psd
_________________, OCT/TCT No. _______________, Tax Declaration ______________;

3. Over a portion of said land/lot, ___________________________, likewise of legal age, Filipino,

single/married and resident of _________________________________ is given permission to
construct his/her building and electrical service wiring;

4. I am giving my full and unequivocal consent for ________________________________ or any

member of his/her family or another person under his/her express or implied authority, to apply for
electric service over a portion of my property under his/her name;

5. I undertake to be jointly and severally liable to DASURECO with __________________________

for any unpaid regular monthly bills incurred by him/her after leaving the premises, in the absence
of or insufficiency of the bill deposit, but not to exceed two (2) months;

6. I shall inform DASURECO in writing for any revocation of the right of

___________________________ to occupy the subject premises and that it shall only be effective
upon receipt by DASURECO of the written revocation; and

7. I execute this affidavit freely and voluntarily.

IN WITNESS WHEREOF, I hereunto set my hand on ___________________ at

_______________________________.

_____________________________
Affiant

_____________________________

SUBSCRIBED AND SWORN to before me this ____________________ at

_________________________________, Philippines, affiant showing his/her _______________________
with number as above indicated.

Doc. No. ___________________;

Page No. ___________________;
Book No. ___________________;
Series of 20_______.