Republic of the Philippines )

_______________________ )S.S.

AFFIDAVIT OF UNDERTAKING
We, ___________________, both of legal age, Filipinos, married, respectively, and with office address at
____________________________sworn to in accordance with law, hereby depose and say that:

1. We are respectively the ___________ of the _______, a _______ under the _____________, duly
organized and existing under and by virtue of the laws of the Republic of the Philippines, and having its
principal office at ______________;

2. _____________, through a letter correspondence dated _________________, sought the permission and
asked for clearance from the _______________________ to reestablish its xxxxxxxxxxxxxxxx situated at
xxxxxxxxxxxxxxxxxxx. A copy of the said correspondence is attached herewith as “Annex A” and shall
form an integral part of this document;

3. On xxxxxxxx through the xxxxxxxxxxxxxxxxx, answered the letter and hereby accepted the proposal of
xxxxxxxxx upon the performance of certain conditions therein stated. A copy of the reply letter dated
xxxxxxxxxxxxxxxx is attached herewith as “Annex B” and shall form an integral part of this document;

4. The conditions to be performed by the xxxxxxx as stated in the reply letter of the xxxxxx are the following:
a. that the xxxxxxxxxxxxwill not affect all xxxxxxxxxxxx systems presently installed thereat,
b. that the xxxxxxxxxxxxx shall conform to the policies and plan; and
c. that the will utilize safety measures and considerations;

5. In the event of any future camp enhancement undertaken under the xxxxxx which would require the need to
occupy the space wherein the xxxxxxxxxxxxx is located, we hereby undertake that the xxxxxxxxxxx will
dismantle the xxxxxxxxx at no cost, and that xxx shall hold the xxxxx free from any liability, expense, or
damage that may arise as a consequence of the dismantling procedure.

6. We are executing this Affidavit of Undertaking for all legal intents and purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of __________________________ at
___________________________, Philippines.

Affiant

SUBSCRIBED & SWORN TO BEFORE ME this ____ day of ____________, 2019, Affiant exhibiting to me
his competent evidence of identity _____________________, ID No. _____________________, issued at
_________________________ issued on ___________________________ and valid until
_____________________________.

Doc. No. ______

Page No. _____
Book No. _____
Series of 2019