Republic of the Philippines

Department of Transportation and Communication

LAND TRANSPORTATION OFFICE
Cordillera Administrative Region
LTO-OPERATIONS DIVISION
Upper Session Road, Baguio City
Republic of the Philippines)
Done: In the City of Baguio) s.s.

AFFIDAVIT OF UNDERTAKING
I, MARGARITA A. HORA, of legal age, married, Filipino Citizen, with
residence and postal address at Shilan, La Trinidad, Benguet, Philippines
after having been duly sworn to in accordance with law hereby depose and
state:
1. That sometime in the First Week of January this year, I went to the
Land Transportation Office (LTO), Wangal, La Trinidad Office to
register a Motor Vehicle with Plate Number ZAX 991 (2005 Freedom
White Toyota S), to my shock and surprised, a blotter (LTO49) Alarm
Data Entry Public Utility Vehicle was imposed on the said Vehicle,
hence, cannot be registered, because a penalty was imposed on me
without due process which I am entitled and protected by law;
2. That I inquired in the LTO office what is the reason and I was shown
a Letter-Complaint by a certain Zaldy Simeon with CP No.
09292189403 which I immediately contacted his number but did not
answer;
3. That I remember that on December 23, 2012, I was driving near the
gate of the Camp Dangwa, La Trinidad, Benguet wherein the traffic
is bumper to bumper then a motorcycle suddenly swerved coming
on my right side then I was following until Km. 6, La Trinidad,
Benguet;
4. That even in his letter-complaint, it states When his driven vehicle
was bumped from behind and fled away by the unknown type of
vehicle with plate number ZAX 991 when he was on temporary stop
due to traffic congestion, so, how could I have fled if the traffic is
congested;
5. That however, should Mr. Simeon will show-up and proved his
allegation of damages, I will be more than willing to
pay/compensate what is legally due;
6. That so, I would be involuntarily violating the law of not registering
my vehicle, I am requesting that the Alarm be lifted and I will be
allowed to register my vehicle;

7. In my record on driving and registering my vehicle, I dont have any

lapses or violation;
8. I am executing this affidavit to attest to the veracity and
truthfulness of the foregoing and to support the lifting of the Alarm
and I will register my vehicle in compliance with law and for all legal
intents and purposes it may serve.
IN WITNESS HEREOF, I have hereunto set my hand this 30 th day of
January, 2015 at Baguio City, Philippines.
MARGARITA A. HORA
Affiant
SUBSCRIBED AND SWORN to before me this 30th day of January,
2015 at Baguio City, Philippines. Affiant personally appeared before me
known to me personally and to be the same person who executed this
instrument based on her personal knowledge and authentic document.

MODESTO T. ANDONG
Notary Public
Commission No. 30-NC-14-R/Until: December 31, 2015
PTR No. 2010843/1-05-15/Baguio City
IBP No. 0980515/1-05-15/Baguio-Benguet Chapter
Roll No. 31289/5-15-81/Manila
MCLE COMPLIANCE No. V-0002709/July 3, 2014
Community Tax Certificate Number 15051806
Issued On: January 5, 2015
Issued At: Baguio City
No. 13-B, 2nd Floor Old Market Bldg.,
Magsaysay Ave., Baguio City, Philippines

Doc. No. 074;

Page No. 15;
Book No. 11;
Series of 2015.