Affidavit of Undertaking - Single Motorcycle

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Republic of the Philippines)

Province of Surigao del Sur)s.s.


City of Tandag . . . . . . . .)
x - - - - - - - - - - - - - - - - - - -/

AFFIDAVIT OF UNDERTAKING

I, RAMEL H. GAY, of legal age, Filipino, married and a presently residing at


Mabahin, Cortes, Surigao del Sur, Philippines after having been duly sworn to in
accordance with law hereby depose and say:

1. That I am the owner of a single motorcycle, particularly described below:

Make: JIANGMEN HAOUJE


Color: Black
Engine No.: 156FM12B1N04926
Chassis No.: LC6PCJD67A0804495
Year Model: 2010

3. That on December 16, 2015, at around 1:30 o’clock in the morning, my


motorcycle was apprehended at Matho, Cortes, Surigao del Sur, allegedly for
transporting lumbers without permit or documents;

4. That as a consequence, my motorcycle has been impounded at Cortes Police


Station, Cortes, Surigao del Sur;

5. That as the owner of the said motorcycle, I earnestly request the Chief of
Police of Cortes, Surigao del Sur, that it be released to me and I hereby
undertake to present the same to the DENR/Police Station/court whenever it
is required or needed;

6. That I am executing this affidavit to attest to the truthfulness of the


foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of


December 2015 in Tandag, Surigao del Sur, Philippines.

RAMEL H. GAY
Affiant

SUBSCRIBED AND SWORN TO before me this 17th day of December 2015 at


Cortes, Surigao del Sur, Philippines.
Republic of the Philippines)
Province of Surigao del Sur)s.s.
City of Tandag . . . . . . . .)
x - - - - - - - - - - - - - - - - - - -/

AFFIDAVIT OF UNDERTAKING

I, NELSON D. DEDIOS, of legal age, Filipino, married and a presently residing


at Mabahin, Cortes, Surigao del Sur, Philippines after having been duly sworn to in
accordance with law hereby depose and say:

2. That I am the owner of a single motorcycle, particularly described below:

Make: TC 150-Z
Color: Red
Engine No. RW1621FMJ*JAO10830
Chassis No. RWCLPK207FE010830

7. That on December 16, 2015, at around 1:30 o’clock in the morning, my


motorcycle was apprehended at Matho, Cortes, Surigao del Sur, allegedly for
transporting lumbers without permit or documents;

8. That as a consequence, my motorcycle has been impounded at Cortes Police


Station, Cortes, Surigao del Sur;

9. That as the owner of the said motorcycle, I earnestly request the Chief of
Police of Cortes, Surigao del Sur, that it be released to me and I hereby
undertake to present the same to the DENR/Police Station/court whenever it
is required or needed;

10.That I am executing this affidavit to attest to the truthfulness of the


foregoing facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of


December 2015 in Tandag, Surigao del Sur, Philippines.

NELSON D. DEDIOS
Affiant

SUBSCRIBED AND SWORN TO before me this 17th day of December 2015 at


Tandag, Surigao del Sur, Philippines.

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