Republic of the Philippines

Province of Northern Samar ss.

Municipality of Catarman

AFFIDAVIT OF UNDERTAKING

I, RODNELYN ADRAYAN HUAVAS, of legal age, married,

with residence at Brgy. Bagasbas, Mondragon, Northern Samar,
under oath, depose and state:

1. That on October 14, 2016 at 08:30 in the morning at Brgy.

Santol, Catarman, Northern Samar while I was driving a
Hyundai Grace Van, owned by Erwin Timbre, I accidentally
bumped an XRM Motorcycle, driven by certain Jericho
Almasco.

2. That because of the said incident,I voluntarily turn over the

said vehicle to the police authorities of Catarman Philippine
National Police Station;

3. The vehicle is particularly described as follows:

A Hyundai Grace Van, color green with Plate No. XDJ

196, Engine No. D4BXP522459 and Chassis No.
KMJFD37APRU124414.

4. That right after the incident, the victim was immediately

brought to Northern Samar General Hospital for medical
attention;

5. I am now requesting the PNP to release to me the Hyundai

Grace Van;

6. That with this predicament, I undertake that in the event

said motor vehicle is needed by the authorities in support of
any claim or case of whatever nature against me in relation
to the cause of such impoundment, I will cooperate to bring
it back to the authority;

7. That I execute this affidavit to support my request from the

PNP Catarman for the release of the Hyundai grace Van
which is presently under their custody.

IN WITNESS WHEREOF, I have hereunto set my hand this

14th day of October 2016 at Catarman, Northern Samar, Philippines.

ALEXANDER G. PELONIA
Affiant

SUBSCRIBED AND SWORN TO before me this 14th day of

October 2016 at Catarman, Northern Samar, Philippines, affiant
exhibited to me his Driver’s License No. H06-01-009648 as
competent proof of identity.

Doc No. _____;

Page No. _____;
Book No. _____;
Series of 2016.