Republic of the Philippines)

Province of Masbate ) S.S.

City of Masbate )

AFFIDAVIT OF UNDERTAKING

I, Cesar A. Ramirez, of legal age, Filipino and a resident of 156 Ibingay, Masbate City after
having been duly sworn to in accordance with law, hereby depose and say:

That I am the lawful owner of a Kawasaki Barako motorcycle with side car.

That unintentionally I was involved in an accident against a Toyota Hilux Pick up Truck with Plate
No. VEP 662.

That I undertake to pay all expenses necessary for the repair of such damage of the vehicle
owned by Dr. Allan F. Comin.

Further I certify that I will pay the said amount without demand.

That Dr.Allan F. Comin agreed that my motorcycle be released under custody with this
undertaking that I will pay damages for the repair of his HILUX pick up be paid.

That I have executed this affidavit to attest to the truth of all the foregoing and for whatever
purpose this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this 31st. day of July, 2017 in the City of
Masbate, Philippines.

__________________________
Affiant
With my conformity:

_________________
Allan F. Comin

SIGNED IN THE PRESENCE OF:

_______________________ _______________________

JURAT

SUBSCRIBED AND SWORN to before me this ____________ affiant exhibited to me his driver’s
License no. EO3-92-004926 Valid until Dec. 10, 2017.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017;