Republic of the Philippines )

Province of Negros Oriental..) S.S.

Municipality of Sibulan)

AFFIDAVIT OF UNDERTAKING

I, PACITA CAFINO RIO, of legal age, Filipino, single, and a resident of Magatas,
Sibulan, Negros Oriental, after having been sworn to in accordance with law, do hereby depose
and state:

1. That I am a registered voter of Looc, Dumaguete City, Negros Oriental,

Philippines;

2. That I am applying for the transfer of my registration record at the local

COMELEC office of Sibulan, Negros Oriental, Philippines;

3. I undertake to process and apply for the transfer of my registration record at the
local COMELEC office of Sibulan, Negros Oriental, Philippines for the transfer of my voter
registration specifically in Magatas, Sibulan, Negros Oriental;

4. That I in effect exclude any authorities of the government and its offices for any
liability (administrative, civil or criminal) from any related incident/s that may arise ;

5. That I executed this affidavit to attest to above-stated facts for whatever legal
purpose it may deem serve and for the purpose of transfering my registration record;

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___________ in

Sibulan, Negros Oriental, Philippines.

PACITA CAFINO RIO

Affiant

SUBSCRIBED AND SWORN to before me this _______________ in Sibulan, Negros

Oriental, Philippines, personally appeared, PACITA CAFINO RIO, who exhibited to me her
VOTERS ID VIN: 4610-0169A-K3061PCR20000 and she attested that she is the same person
who personally signed before me the foregoing affidavit and acknowledged that she voluntarily
executed the same.

Doc No. ___;

Page No. ___;
Book No. __;
Series of 2023.