REPUBLIC OF THE PHILIPPINES )

CITY OF ______________ ) SS.

AFFIDAVIT OF UNDERTAKING

I, JULITO MANGUPOT , of legal age, single/married, Filipino,

with office/residence and postal address at B50 L4 P4 WELLINGTON RESIDENCE BRGY.
TRES CRUSES TANZA CAVITE, in accordance with law, do hereby depose and say – THAT:

1. I am the owner/manager/duly authorized representative of business establishment

named HABBI GAS RETAILING and JS STORE located at
B50 L4 P4 WELLINGTON RESIDENCE BRGY. TRES CRUSES TANZA CAVITE ;

2. I am securing a business permit and license from the Business Permits and Licensing
Office (BPLO), Municipal Government of Tanza Cavite for the aforesaid business;

3. I am aware of the terms and conditions laid down by laws for the promotion of
health and safety, improvements of public morals, maintenance of peace and order,
preservation of comfort and convenience of the inhabitants and the promotion of
general welfare in general;

4. That I undertake that the items will only be THREE LPG ONLY for IN and OUT Process.

5. In case of violation of any of the foregoing, I interpose no objection to the automatic

suspension, cancellation or revocation, as the case may be, of my business permit
and license, and the subsequent closure of the above-cited business establishment, if
necessary;

6. That I execute this affidavit in order to attest the truth of the above facts for all legal
intents and purposes it may serve;

AFFIANT FURTHER SAYETH NAUGHT.

JULITO MANGUPOT
Affiant

SUBSCRIBED AND SWORN to before me this day of _ in the

_____________, affiant having exhibited to me his/her ID
bearing No. issued by the and valid
until___________ .

Doc No. _____; Notary public

Page No. ____;
Book No.____ ;
Series of ____: