REPUBLIC OF THE PHILIPPINES)

CITY OF TARLAC . . . . . . . . . )S.S.

AFFIDAVIT OF UNDERTAKING
I, MICHAEL A. LUMBOY, pof legal age, married, Filipino citizen, and a resident of Northern Hills
Subdivision, Brgy. San Vicente, Tarlac City, after having been duly sworn to in accordance with law,
do hereby state – THAT;
1. I am the owner/proprietor of DHIKZ INTERNET SHOP, with business address at Blk.
5, Gumamela St. San Vivente, Tarlac City;
2. The said business establishment offers the following services, to wit;
a) internet
b) gaming
c) encoding/scanning/printing
d) related computer works
3. As the owner/proprietor, I hereby undertake to prohibit minors from entering said
business establishment during school days from 8:00AM – 5:00PM;
4. Likewise, I undertake to observe the curfew for minors pursuant to existing Barangay
and City ordinance;
5. Further, I undertake to ensure that no illegal activities shall be perpetrated within the
premises of the business establishment;
6. Furthermore, I undertake to comply with all existing laws, rules and regulations as
implemented/enacted under pertinent barangay and city ordinances;
7. I am executing this affidavit to attest to the truth of the foregoing declarations and in
support of my application for the issuance of business permit.

IN WITNESS WHEREOF, I have hereunto set my hands this ___________________,

Tarlac City, Philippines.

MICHAEL A. LUMBOY
Affiant

SUBSCRIBED AND SWORN to before me this ___________________, Tarlac

City, Philippines.
WITNESS MY HAND AND SEAL.

Doc No. _____;

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