REPUBLIC OF THE PHILIPPINES )

_________________________ ) S.S.

AFFIDAVIT OF UNDERTAKING

I, ___________________________, of legal age, married, Filipino, with

residence and postal address at Zone 1, San Isidro, Baao, Camarines Sur, after
having been duly sworn to in accordance with the law, hereby depose and state
that:

1. I am the owner of JEANLEX ANN CONSTRUCTION AND SUPPLIES

Branch, located at National Highway Del Rosario, Baao, Camarines
Sur;

2. I recognize the authority of the Baao Municipal Engineering Office to

evaluate the completeness of the documents necessary for the
issuance of a Building Inspection Certificate as a requirement for
Mayor’s Permit;

3. 2023 would be the last year that the business will be operating in the
above-mentioned barangay as I intend to close the same for
streamlining purposes;

4. This affidavit is voluntarily executed in order to attest to the

truthfulness of the foregoing narration of facts and to request for the
issuance of a Building Inspection Certificate from the Office of the Baao
Municipal Engineer.

IN WITNESS WHEREOF, I am affixing my signature this _______ day of

_____________________ 20_____ in
___________________________________.

______________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this ______ day of

____________ 20_________ at _________________________ Philippines.
Affiant exhibited to me his/her valid government issued Identification (ID) with
number _____________ and issued on _______________________ at
_________________________________.

Doc. No. __________;

Page No.__________;
Book No.__________;
Series of __________.