REPUBLIC OF THE PHILIPPINES )

_____________________ ) S.S.

AFFIDAVIT OF UNDERTAKING
I, JUAN DELA CRUZ, of legal age, married, Filipino with postal address at Talisay Cebu
6045, after having been sworn in accordance with the law hereby depose and state that:

1. I am the Regional Manager XXX Cargo Logistics Corporation with its branch office at
Mandaue Cebu;

2. That I am in custody and at the same time supervising the operation and transport of cargo
vehicles used to transport different merchandise (motor vehicle units) to different parts of
the Visayas region as well as cargo from Cebu to Manila vis-à-vis;

3. That one of our vehicle particularly ZZZ forward double decker truck bearing Plate No. ABC
1234 registered in the name of XXX Cargo Logistics Corporation was driven by our driver in
the name of MARIO DONTKNOW a resident of Brgy. San Miguel, Leyte and is a holder of
an LTO Professional Driver’s License with No. aaa-19-000001 valid until 2023/06/30;

4. That above described motor vehicle driven by MARIO DONTKNOW was involved in an
accident that occurred sometime last April 01, 2019 approximately 3:00 o’clock in the
afternoon along the National Highway XYZ Leyte , whereby it accidently hit or bumped the
rear portion of a Commuter Van Utility vehicle with plate No. 123456 registered in the name
of ASIONG SALONGA. The said accident caused damaged to both vehicles. Such fact is
embodied in the police blotter hereto attached as Annex “A”;

5. Because of such incident, our company vehicle (ZZZ forward double decker truck) was
impounded by the authorities specifically the xxx Police Station;

6. I hereby undertake to produce said vehicle upon request of the authorities if such will be
needed for further proceedings or investigation;

7. This affidavit is being executed to support my request for the release of the impounded
vehicle;

8. Further, I am executing this undertaking to attest to the truth of the foregoing.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREFOR, I have hereunto set my hands this ______ day of

_______________, 2019 in _________________, Philippines.

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN TO before me this _____ day of ________, 2019 in

________________, affiant exhibiting to me his _____________ issued on
___________________ in ___________________, Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.

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