REPUBLIC OF THE PHILIPPINES)

PROVINCE OF OCCIDENTAL MINDORO)S.S

MUNICIPALITY OF SABLAYAN)

AFFIDAVIT OF UNDERTAKING AS CUSTODIAN

I, ( NAME OF BARANGAY CAPTAIN), Filipino, of legal age, (married/single)

and with residence and postal address at___________, Barangay ___________,
Sablayan, Province of Occidental Mindoro, after having duly sworn in
accordance with law, hereby depose and say:

1. I am the incumbent Punong Barangay of Barangay _____________,

Municipality of Sablayan;

2. That (Name of Accused), is one of the residents of our Barangay;

3. I was informed that (Name of Accused) has applied to be released on

bail having been accused for the crime of Violation of PD 1602 by the
Municipal Trial Court of Sablayan and docketed as Criminal Case No. 6400;

4. I was further made to understand that (Name of the Accused) desires

to be released on bail pending the litigation of the case and needs a custodian
for this purpose;

5. I hereby agree to be the custodian of (Name of the Accused) and

undertakes to bring him to the court whenever required;

6. I am executing this affidavit to apprise all those concerned of the

foregoing facts and for whatever other legal purpose it may serve.

WHEREFORE, in order to attest to the truth of the foregoing, I am

hereby affixing my signature to this Affidavit of Undertaking this_____of______,
2018 in the Municipality of Sablayan, Province of Occidental Mindoro.

PB_______________________
Affiant

PERSONALLY CAME AND APPEARED BEFORE ME,

_______________________________exhibiting to me
her_________________________with
number_____________________________ issued on
______________________at__________________________________, known
to me to e the same person who executed the foregoing
undertaking, and acknowledged that the same is her free and act
and voluntary deed this______day of____________, 2018 at Sablayan
Occidental Mindoro.

WITNESS MY HAND AND SEAL.

Doc No. __________;

Page No.__________;
Book No.__________;
Series of 2018