Republic of the Philippines )

Municipality of___________) S. S.
Province of Nueva Vizcaya )

AFFIDAVIT OF UNDERTAKING

I, TIRSO L. TABAGO JR., of legal age, married, Filipino citizen, and a

resident of Brgy. San Geronimo, Bagabag, Nueva Vizcaya, after having been duly
sworn in accordance with law, hereby depose and states:

1. That I am the owner of the grey pajero bearing plate number XLU 898
vehicle involved in the incident last 12 July 2018 which hit the green pick-
up bearing plate number SFW 258 registered in the name of the Department
of Agrarian Reform (DAR) Provincial Office of Nueva Vizcaya;

2. That I together with the Chief Administrative Officer of the DAR agreed to
settle things amicably to avoid the filing of a civil or criminal case;

3. That I will shoulder the participation expense in the insurance policy of the
vehicle owned by DAR as mentioned above, such will serve as a condition
on the immediately preceding paragraph;

4. That I, TIRSO L. TABAGO JR., assure and take full responsibility of

shouldering the participation expense or the expenses necessary to the
repair of the vehicle owned by DAR which is caused by the incident that are
not covered by the vehicle’s insurance;

IN WITNESS WHEREOF, I have hereunto set my hand, this____ day of July,

2018 at_____________________, Philippines.

TIRSO L. TABAGO JR.

AFFIANT
ID No.:____________________
Issued On;_________________
Issued At:__________________

SUBSCRIBED AND SWORN to before me this ____ day of July, 2018

at__________________, Philippines, affiant exhibiting to me his valid identification
as indicated below his name.

Doc. No.____
Page No.____
Book No.____
Series of 2018