Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we: Spouses PETER C. LEE and ALFA A. LEE, both of legal age, both Filipinos,
both residents of Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following, THAT:

1. We are the transferees of portion of parcel of land more particularly

described as follows:

“A parcel of land Lot 1097-A situated at Birayan, Katipunan, Zamboanga

del Norte, and covered by Transfer Certificate of Title No.T-80587,
containing an area of 44,358 square meters issued by ROD for
Zamboanga del Norte”

2. The above stated parcel of land is agricultural land/s;

3. The area transferred to us is classified as agricultural land, we warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
4. In the future, should we decide to change its use from agricultural to residential,
commercial or industrial, we undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
5. We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against us.
6. We are executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

PETER C. LEE and ALFA A. LEE

Affiant
TIN#499-542-434/TIN#297-274-466

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: ROLANDO CAVAN MARTINEZ,JR, of legal age, Filipino,

single/married, resident of Galas, Dipolog City, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose
and say the following, THAT:

7. I am registered taxpayer with Tax Identification Number 152-

330-991;
8. As taxpayer, I have been religiously paying my taxes;
9. I undertake that I have no unpaid/delinquent taxes with the
Bureau of Internal Revenue and should there be
unpaid/delinquent taxes, I will immediately pay it;
10.I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

__th day of ___________2024, at Dipolog City, Philippines.

ROLANDO CAVAN MARTINEZ,JR

Affiant
Valid ID#______________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________

2024, at Dipolog City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: MADELLIENE Y. BELMONTE, of legal age, Filipino, resident of Sicayab,

Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

11. I am transferee of parcel of land more particularly described as follows:

“A parcel of land Lot 3091-C-8, situated at Poblacion Bajo, Sergio Osmena,

Zamboanga del Norte, and covered by Transfer Certificate of Title No.127-
2022001685, containing an area of 27,767 square meters issued by ROD for
Zamboanga del Norte”

12. The above stated parcel of land is agricultural land/s;

13. The area transferred to me is classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
14. In the future, should I decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
15. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
16. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this __th day of
___________2024, at Dipolog City, Philippines.

MADELLIENE Y. BELMONTE
Affiant
Valid ID#______________
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: EUPHRETES TABURA,JR, of legal age, Filipino, single, resident of

49 J Tabura St., Poblacion, Pardo, Cebu City, after having been duly sworn
to an oath in accordance with law, do hereby depose and say the following,
THAT:

17.I am the companion of minor PETE RAFAEL BANDALA who

together with me will travel Malaysia and Thailand to
participate in the International Tennis Tournament to be held on
November 30, 2024 to December 13, 2024;
[Link] RAFAEL BANDALA is the child of IAN PETE T.
BANDALA who gave his full consent and permission to me as
the companion of his son;
19.I am the chaperon and coach of PETE RAFAEL BANDALA;
20.I hereby undertake and affirm that, I together with the minor
child above-mentioned will return to the Philippines as soon as
we finish the duration of our travel to Malaysia and Thailand,
and promise to inform the Minors Traveling Abroad Section,
DSWD IX Office 5 days upon arrival;
21.I assume full responsibility over the minor’s safety and welfare
during the entire duration of our travel and stay at Malaysia and
Thailand, and hold the staff, officers and/or employee of DSWD
 IX free and harmless from all or any liability arising from the
travel of the said minor child.
22.I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

__th day of ___________2024, at Dipolog City, Philippines.

EUPHRETES TABURA,JR.
Affiant
Valid ID#______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2024, at Dipolog City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF AGE OF VENDEE

I: MARY ANGELYN E. ELAGOR-LABISIG, married to Hansson G.

Labisig, of legal age, Filipino, and resident of Poblacion South, Polanco, Zamboanga del
Norte, after having been duly sworn to an oath in accordance with law, do hereby depose
and say the following, THAT:
 23. I am the mother HARPER ADELAIDE E. LABISIG, a minor, and I
exercise parental authority over the said child;
24. My said child is the vendee in a Deed of Absolute Sale of a Parcel of Land
covered by Transfer Certificate of Title No.T-43828 issued by the Register
of Deeds for Zamboanga del Norte which is situated at Dapdap, Poblacion
South Polanco, Zamboanga del Norte in August 2024;
25. My said child was born on October 14, 2021 in Taguig City, hence my
said child was on three(3) years old when the deed was executed;
26. I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

MARY ANGELYN E. ELAGOR-LABISIG

(Affiant)
Driver’s License#J01-14-003503 valid until 2033/02/13
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
That I: GLAIZA ALEO PAGALING, of legal age, Filipino, single/married, resident of
Taguilon, Dapitan City, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

27. I have an existing insurance policy with St Peter Life Plan, Inc.;
28. My Contract Policy Number is L20375183E;
29. I had missed my monthly premiums with said policy;
30. I have intention of reinstating my aforementioned policy;
31. I hereby undertake to faithfully pay regularly the monthly premiums of
aforecited policy after reinstatement;
32. I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

GLAIZA ALEO PAGALING

Affiant
Valid ID#______________

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: ELREYNAN D. PALMA, of legal age, Filipino, married to Joan Castillo, resident
of Dansullan, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

33. I am transferee of portion of parcel of land more particularly described as

follows:

“A parcel of land Lot 6174-E-3-B-2-C,Psd-09-070565 situated at Betlehem,

Polanco, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.127-2021001004, containing an area of 9,076 square meters issued by ROD
for Zamboanga del Norte”

34. The above stated parcel of land is agricultural land/s;

35. The area transferred to me is classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
36. In the future, should I decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
37. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
38. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this __th day of
___________2024, at Dipolog City, Philippines.

ELREYNAN D. PALMA
Affiant
Valid ID#______________

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: ARCELINO W. SELBANO, of legal age, Filipino, married to Genelyn B.

Selbano, resident of San Vicente, East Poblacion, Manukan, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

39. I am transferee of portion of parcel of land more particularly described as

follows:

“A parcel of land Lot 2042-D-3, Pland No.:Psd-09-090819 situated at Poblacion,

Manukan, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.127-2024000071, containing an area of 9,587.25 square meters issued by
ROD for Zamboanga del Norte”

40. The above stated parcel of land is agricultural land/s;

41. The area transferred to me is classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
42. In the future, should I decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
43. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
44. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this __th day of
___________2024, at Dipolog City, Philippines.

ARCELINO W. SELBANO
Affiant
Phil ID#4085-7269-7503-6102

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: JENNIFER L. SUBRADO, of legal age, Filipino, married to Raymond B.

Subrado, resident of San Vicente, East Poblacion, Manukan, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

45. I am transferee of portion of parcel of land more particularly described as

follows:

“A parcel of land Lot 2042-D-3, Pland No.:Psd-09-090819 situated at Poblacion,

Manukan, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.127-2024000071, containing an area of 9,587.25 square meters issued by
ROD for Zamboanga del Norte”

46. The above stated parcel of land is agricultural land/s;

47. The area transferred to me is classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
48. In the future, should I decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
49. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
50. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this __th day of
___________2024, at Dipolog City, Philippines.

JENNIFER L. SUBRADO
Affiant
Philhealth ID#14-201902283-7

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: FE ELUMBARING BAID, of legal age, Filipino, married, resident of

Poblacion, Sibutad, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the beneficiary of NUSTRIANA E. BAID who had a bank account,

more specifically described as follows:
SAVING DEPOSIT in the amount of TEN THOUSAND EIGHT HUNDRED
TWENTY-THREE PESOS and TWENTY-FIVE CENTAVOS(P10,823.25) per
Passbook No.00124 at ZAMBOANGA DEL NORTE COOPERATIVE BANK-Dipolog
City under Account No.10A000092;

That Nustriana E. Baid died intestate; That I undertake and declare that I am the
beneficiary of Nustriana E. Baid and I am entitled to the said account;

That for and in consideration of my/our receipt of the amount plus the accruing
interests, representing proceeds of said account(the “Account”). I/we hereby expressly
and absolutely remiss, release and forever discharge ZAMBOANGA DEL NORTE
COOPERATIVE BANK, its owners, directors, stockholders, officers, employees and
assignes from any and all claims, suits, actions or causes of action which we, my/our
successors/assignes now have or in the future claims to have against ZAMBOANGA
DEL NORTE COOPERATIVE BANK in connection with the Account;

That I/we hereby further obligate myself/ourselves, jointly and severally to

indemnify ZAMBOANGA DEL NORTE COOPERATIVE BANK for any loss or
damages which it may sustain in the event that any third person/s shall succeed in
establishing a right superior to that of mince/ours concerning the Account.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of

September 2024, at Dipolog City, Philippines.

FE ELUMABRING BAID
(Affiant)
Driver’s License#J01-88-008913
With photo

SUBSCRIBED AND SWORN to before me this ___ day of September 2024, at

Dipolog City.
Doc. No.
Page No.
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF WAIVER TO FILE COMPLAINT

I, RICHARD B. VILLAR, of legal age, Filipino, married, a resident of Lingasad,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly described as

follows;

MAKE: ISUZU SERIES: DROPSIDE

PLATE NO.:TNZ 394 MV FILE NO.1312-63343
ENGINE NO.:4BC2127879 CHASSIS NO.:KT264829806
CR NO.27425654

That,the said vehicle was utilized to transport coco lumber however it was
impounded after it was apprehended by the Philippine Coconut Authority upon finding
that no permits were issued, on August 13, 2024 at around or about 10:30 in the morning
in Lingasad, Polanco, Zamboanga del Norte.

That although the said vehicle was impounded by the PCA together with the coco
lumbers, I have no intention to file any complaint against the impounding authorities;

That this affidavit is freely and voluntarily execduted to attest to the truth of the
foregoing that I hereby waive my rights to file any complaint against PCA, their
personnel, who were performing the bounden duties.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th

day of August 2024, at Dipolog City, Philippines.

RICHARD B. VILLAR
(Affiant)
Drivers License#J01-94-018151
Valid until 2033/03/22
 With photo

SUBSCRIBED AND SWORN to before me this 14th day of August 2024, at

Dipolog City.
Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF NON-COMPLICITY

I, RICHARD B. VILLAR, of legal age, Filipino, married, a resident of Lingasad,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly described as

follows;

MAKE: ISUZU SERIES: DROPSIDE

PLATE NO.:TNZ 394 MV FILE NO.1312-63343
ENGINE NO.:4BC2127879 CHASSIS NO.:KT264829806
CR NO.27425654

That,the said vehicle was utilized to transport coco lumber however it was
impounded after it was apprehended by the Philippine Coconut Authority upon finding
that no permits were issued, on August 13, 2024 at around or about 10:30 in the morning
in Lingasad, Polanco, Zamboanga del Norte.

That I have no personal angst, conflict and prejudice against the apprehending and
seizing authorities of my motor vehicle, thus, I fully recognize that they are just doing
their bound duties;

That I hereby undertake not to use the said motor vehicle in any illegal activity or
any transportation of coconut lumber without the pertinent permits issued by the
government; and
 That I am executing this affidavit in order to attest the truthfulness and veracity of
the foregoing statements and to request for the release of the subject motor vehicle.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th day of

August 2024, at Dipolog City, Philippines.

RICHARD B. VILLAR
(Affiant)
Drivers License#J01-94-018151
Valid until 2033/03/22
With photo

SUBSCRIBED AND SWORN to before me this 14th day of August 2024, at

Dipolog City.
Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

REQUEST FOR RELEASE OF MOTOR VEHICLE

I, RICHARD B. VILLAR, of legal age, Filipino, married, a resident of Lingasad,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly described as

follows;

MAKE: ISUZU SERIES: DROPSIDE

PLATE NO.:TNZ 394 MV FILE NO.1312-63343
ENGINE NO.:4BC2127879 CHASSIS NO.:KT264829806
CR NO.27425654

That,the said vehicle was utilized to transport coco lumber however it was
impounded after it was apprehended by the Philippine Coconut Authority upon finding
that no permits were issued, on August 13, 2024 at around or about 10:30 in the morning
in Lingasad, Polanco, Zamboanga del Norte.

That Administrative Order No.1 series of 2013, Section 45(c) provides that:
“vehicles impounded for the first time pursuanct to the preceding paragraph shall
be released by the PCA to their owners after they have sufficiently shown that they have
no complicity in the illegal cutting of the coconut trees, logs of lumber confiscated.”

That I forthwith execute the pertinent Affidabit of Non-complicity as required by

PCA which is hereto attached as ANNEX “A”;
 That the continuing impoundmnent of the motor vehicle will render unnecessary
deterioration as well as cause prompt wear and tear that will ultimately render it
unserviceable;

That I undertake not to use the said vehicle in any illegal activity or any transport
of coconut lumber without the pertinent permits issued by the government;

That I am executing this affidavit in order to attest the truthfulness and veracity of
the foregoing statements and to request for the release of the subject motor vehicle.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th day of

August 2024, at Dipolog City, Philippines.

RICHARD B. VILLAR
(Affiant)
Drivers License#J01-94-018151
Valid until 2033/03/22
With photo

SUBSCRIBED AND SWORN to before me this 14th day of August 2024, at

Dipolog City.
Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RICHARD B. VILLAR, of legal age, Filipino, married, a resident of

Lingasad, Polanco, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: ISUZU SERIES: DROPSIDE

PLATE NO.:TNZ 394 MV FILE NO.1312-63343
ENGINE NO.:4BC2127879 CHASSIS NO.:KT264829806
CR NO.27425654
 That,the said vehicle was utilized to transport coco lumber however it was
impounded after it was apprehended by the Philippine Coconut Authority upon
finding that no permits were issued, on August 13, 2024 at around or about 10:30
in the morning in Lingasad, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicle was impounded by the
Philippine Coconut Authority of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Philippine Coconut Authority/Honorable Prosecutor or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th

day of August 2024, at Dipolog City, Philippines.

RICHARD B. VILLAR
(Affiant)
Drivers License#J01-94-018151
Valid until 2033/03/22
With photo

SUBSCRIBED AND SWORN to before me this 14th day of August 2024,

at Dipolog City.
Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF QUITCLAIM WITH UNDERTAKING

I, ORLY INSO COGO, of legal age, Filipino, single/married, a resident of

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:
 51. I hereby state and declare that I have received in full the Health Emergency
Allowance(HEA) benefits for health workers amounting to Forty-one thousand
one hundred eighty-seven Pesos and fifty centavos(P41,187.50) cash, under DOH
AO No.2022-0001-A and 2022-0039 from the Local Government Unit of Pres.
M.A. Roxas, Zamboanga del Norte.

52. I hereby release said Local Government Unit of any future claim which I may
have in relation to the aforementioned HEA;

53. I hereby undertake to return any and all excess amount in full in case I received
HEA benefits twice or more from one(1) or more health facilities;

54. I declare that I fully understood the contents and effects of the Affidavit and that I
execute the same voluntarily and willingly with full knowledge of my rights under
the law.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 9th day of
August 2024, at Dipolog City, Philippines.

ORLY INSO COGO

(Affiant)
Drivers License#J01-07-003386

SUBSCRIBED AND SWORN to before me this 9 th day of August 2024, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, VANESSA C. ACORIN, of legal age, Filipino, single, a resident of Egot,
Turno, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

1. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

2. I am now intending to enroll for the first semester of 2024-2025 School

Year however I still have an outstanding obligation in the amount of
P1,500.00 with our College Department;

3. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P1,500.00 outstanding obligation
with the College Department within this School Year;

4. I have no intention of evading my obligation from the school or my

college department;

5. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd day of

August 2024, at Dipolog City, Philippines.

VANESSA C. ACORIN
(Affiant)
JRMSU School ID#15DF200350
With photo & signature

SUBSCRIBED AND SWORN to before me this 2 nd day of August 2024, at

Dipolog City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, ANGEL NOVY A. LABADLABAD, of legal age, Filipino, single, a resident
of Poblacion, Jose Dalman, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

6. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

7. I am now intending to enroll for the first semester of 2024-2025 School

Year however I still have an outstanding obligation in the amount of
P6,000.00 with our College Department;

8. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P6,000.00 outstanding obligation
with the College Department within this School Year;

9. I have no intention of evading my obligation from the school or my

college department;

10. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 30 th day of

July 2024, at Dipolog City, Philippines.

ANGEL NOVY A. LABADLABAD

(Affiant)
JRMSU School ID#18DF201236
With photo & signature

SUBSCRIBED AND SWORN to before me this 30 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MELOJEN S. BASTASA, of legal age, Filipino, widow, a resident of

Mibang, Sta. Filomena, Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:
 11. I am currently employed by Department of Education(DepEd)-Dipolog
City Division Office;

12. I have applied for salary loan with Chinabank-Dipolog City Branch;

13. I have no intention to resign, retire or terminate my employment from

DepEd until full payment of my loan;

14. I hereby undertake to pay my loan in full;

15. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

MELOJEN S. BASTASA
(Affiant)
PRC ID 0219698, valid until 4/9/2025
With photo & signature

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, JOHN MARK E. TANTOY, of legal age, Filipino, single, a resident of
Sicayab, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

16. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

17. I am now intending to enroll for the first semester of 2024-2025 School
Year however I still have an outstanding obligation in the amount of
P2,500.00 with our College Department;

18. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P2,500.00 outstanding obligation
with the College Department within this School Year;

19. I have no intention of evading my obligation from the school or my

college department;

20. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

JOHN MARK E. TANTOY

(Affiant)
JRMSU School ID#19DF201444
With photo & signature

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, RISSA MAE L. ACOPIO, of legal age, Filipino, single, a resident of Biasong,

Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

21. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

22. I am now intending to enroll for the first semester of 2024-2025 School
Year however I still have an outstanding obligation in the amount of
P1,500.00 with our College Department;

23. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P1,500.00 outstanding obligation
with the College Department within this School Year;

24. I have no intention of evading my obligation from the school or my

college department;

25. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

RISSA MAE L. ACOPIO

(Affiant)
JRMSU School ID#19DF200636
With photo & signature

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RITCHIE T. BALBOSA, of legal age, Filipino, single, a resident of [Link],

Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

26. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

27. I am now intending to enroll for the first semester of 2024-2025 School
Year however I still have an outstanding obligation in the amount of
P7,560.00 with our School;

28. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P7,560.00 outstanding obligation
with the School within this School Year;

29. I have no intention of evading my obligation from the school or my

college department;

30. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

RITCHIE T. BALBOSA
(Affiant)
JRMSU School ID#DC-22-A-00966
With photo & signature

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LANCE R. BADIANG, of legal age, Filipino, single, a resident of Miputak,

Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

1. I am a student of Jose Rizal Memorial State University-Dipolog City Campus;

 2. I am now intending to enroll for the first semester of 2024-2025 School Year
however I still have an outstanding obligation in the amount of P14,000.00
with our School;

3. In view of my acceptance for enrollment pending payment of my obligation, I

undertake to pay the said P14,000.00 outstanding obligation with the School
within this School Year;

4. I have no intention of evading my obligation from the school or my college

department;

5. I am executing this affidavit to attest to the truth of the foregoing statements

and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

LANCE R. BADIANG
(Affiant)
School ID#DC-22-A-00818
With photo

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024
.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LAURENCE L. MEGIO, of legal age, Filipino, single, a resident of Labrador,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

6. I am a student of Jose Rizal Memorial State University-Dipolog City Campus;

7. I am now intending to enroll for the first semester of 2024-2025 School Year
however I still have an outstanding obligation in the amount of P2,000.00 with
our college department;

8. In view of my acceptance for enrollment pending payment of my obligation, I

undertake to pay the said P2,000.00 outstanding obligation with my college
department within this School Year;

9. I have no intention of evading my obligation from the school or my college

department;

10. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 29 th day of

July 2024, at Dipolog City, Philippines.

LAURENCE L. MEGIO
(Affiant)
JRMSU School ID#14DF200986
With photo & signature

SUBSCRIBED AND SWORN to before me this 29 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARIAN JOY BULAT-AG TEQUIL, of legal age, Filipino, single, a

resident of Langatian, Pres. Manuel A. Roxas, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

11. I am currently employed by Department of Education(DepEd)-Zamboanga del

Norte Division Office;

12. I have applied for salary loan with Landbank of the Philippines-Dipolog City
Branch to be released on July 23, 2024;

13. I have no intention to resign or terminate my employment from DepEd until

full payment of my loan;

14. I hereby undertake to pay my loan in full;

15. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 24 th day of

July 2024, at Dipolog City, Philippines.

MARIAN JOY BULAT-AG TEQUIL

(Affiant)
PRC ID 1801799, valid until 10/10/2025
With photo & signature

SUBSCRIBED AND SWORN to before me this 24 th day of July 2024, at Dipolog

City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CECILIA OCHOTORENA ABAMO, of legal age, Filipino, married, a resident

of Katipunan, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

16. I am currently employed by Department of Education(DepEd)-Zamboanga del

Norte Division Office;

17. I have applied for salary loan with Landbank of the Philippines-Dipolog City
Branch to be released on July 23, 2024;

18. I have no intention to resign or terminate my employment from DepEd until

full payment of my loan;

19. I hereby undertake to pay my loan in full;

20. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 22 nd day of

July 2024, at Dipolog City, Philippines.

CECILIA O. ABAMO
(Affiant)
PRC ID 0490961, valid until 07/12/2025
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at

Dipolog City.
DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, WILMERA DENIEGA ELVIÑA, of legal age, Filipino, widow, a resident of

Ramon Magsaysay, Salug, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

21. I am currently employed by Department of Education(DepEd)-Zamboanga del

Norte Division Office;

22. I have applied for salary loan with Landbank of the Philippines-Dipolog City
Branch released on July 17, 2024;

23. I have no intention to resign or terminate my employment from DepEd until

full payment of my loan;

24. I hereby undertake to pay my loan in full;

25. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

WILMERA DENIEGA ELVIÑA

(Affiant)
Deped Employee ID#5140095
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at

Dipolog City.
DOC. NO.5296
PAGE NO.8
BOOK [Link]
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: APPLE RELUYA VELASCO, of legal age, Filipino, single, a resident of

Olingan, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Honda Color: Yellow

Plate No.:563 JZJ Series: Beat

That the said vehicle owned by undersigned was impounded after it was
involved in a vehicular accident that happened on June 9, 2024 at about 6:20 in the
evening along a road at Relocation Site, Barangay Olingan, Dipolog City wherein
the abovementioned motor vehicle driven by Jerome Vidal Alison met an accident
another motor vehicle;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That as of this writing, there is no case filed before the Honorable Court,
hence the said motor vehicle should be released from impoundment;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th

day of July 2024, at Dipolog City, Philippines.

APPLE RELUYA VELASCO

(Affiant)
Drivers License#J01-23-005020
With photo

SUBSCRIBED AND SWORN to before me this 9th day of July 2024, at

Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: MARIFE PARANGAN HISARZA, married to Pedro Hisarza, of legal age,

Filipino, with residence at Miputak, Dipolog City, after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following, THAT:

55. I am an applicant for building permit over a parcel of land more

particularly described as follows:

Lot No. 862-B-20-B-2, Psd-09-053716, situated at Miputak, Dipolog City, containing

an area of One Hundred Twelve (112) SQUARE METERS and covered by Transfer
Certificate of Title No. T-26421;

56. The I became the owner pursuant to Deed of Extrajudicial Partition with
Simultaneous Sale notarized by Atty Methushiela C. Cainta-Bendano per Doc.
No.5460, Page No.8, Book [Link], Series of 2013;
57. The I applied for building permit and other permits using the said title and papers
however the title under my name is not yet issued;
58. I hereby undertake in view of issuance of OBO’s building permit and other
permits that I will submit the new title once it is issued in my name over the said
land, I will not hold the OBO and its officials accountable and liable in the event
of conflict over the said permit or land, I will defend the OBO and its officials in
the event there is/are case/s over the said permit or land, and in any instances,
OBO or its officials have the right to revoke the permit issued in my favor relative
to this application.
59. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

MARIFE PARANGAN HISARZA

Affiant
Passport No.P3267064B

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: RUTH REPAJA, single, of legal age, Filipino, with residence at Poblacion
North, Polanco, Zamboanga del Norte represented by RHODORA F. REPAJA, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

60. I am the transferee of portion of parcel of land more particularly described

as follows:
“A parcel of land situated at Diwan, Dipolog City, and
covered by Transfer Certificate of Title No.(T-7654)128-
2023000427, containing an area of 41,906 square meters
issued by ROD for Dipolog City”

61. The above stated parcel of land is agricultural land/s;

62. The area transferred to me is classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
63. In the future, should I decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
64. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
65. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this __th day of
___________2024, at Dipolog City, Philippines.

RUTH REPAJA
[Link]:
RHODORA F. REPAJA
Affiant
TIN 487-572-281

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: JOYCE VALLECER HIBAYA, married to Edgar D. Hibaya, of legal age,

Filipino, with residence at Sta. Filomena, Dipolog City, after having been duly sworn to
an oath in accordance with law, do hereby depose and say the following, THAT:

66. I am the done of parcels of land more particularly described as follows:

Lot No. 2328-E-3, PSD-09-082104, being a portion of Lot 2328-E, PSD-58733,

situated at Sinaman, Dipolog City, containing an area of FOUR THOUSAND EIGHT
HUNDRED EIGHTY-TWO (4,882) SQUARE METERS and covered by Transfer
Certificate of Title No. 128-2020000609;

and

Lot No. 2328-F-3, PSD-09-082099, being a portion of Lot 2328-F, PSD-58733,

situated at Sinaman, Dipolog City, containing an area of THREE THOUSAND
THREE HUNDRED FORTY TWO (3,342) SQUARE METERS and covered by
Transfer Certificate of Title No. 128-2020000638.

67. The above stated parcels of land are agricultural lands;

68. The area donated to me is classified as agricultural land, we warrant not to change
the actual use of the property from agricultural land use to some other uses or
purposes;
69. In the future, should we decide to change its use from agricultural to residential,
commercial or industrial, I undertake to comply documentary requirements for
Land Use Conversion Order, the application of which , to be filed before the
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City
70. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
 71. I am executing this affidavit to attest to the truth of the foregoing statements for
titling and whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

JOYCE VALLECER HIBAYA

Affiant
UMID CRN-0010-0894167-8

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: JOY KILMARE BETONG, of legal age, Filipino, single, a resident of

Sitog, Katipunan, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am a graduating student of Cebu Institute of Technology –University

with a baccalaureate course of Electrical Engineering ;

That I undertake that I will be cleared from the University Registrar’s

Office and in view thereof I request that I will be allowed to join the graduation
be it face-to-face or virtual, however, the release of my school records will be
pending subject to submission of my annotated and corrected PSA Birth
Certificate;

That I further hereby undertake to comply all the necessary requirements to

correct all my data and/or documents before the School Registrar.

That I hereby attest the truthfulness of foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 24th

day of May 2024, at Dipolog City, Philippines.

JOY KILMARE BETONG

(Affiant)
Valid ID#_______________________
With photo
 SUBSCRIBED AND SWORN to before me this 24th day of May 2024, at
Dipolog City with evidence of identity as shown above.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we: ARNIEL R. LACQUIO, married to Jeanifer C. Lacquio, of legal age, Filipino,
with Philippine residence of San Vicente, Dapitan City and ALBERTO P. MABILIG, of
legal age, Filipino, married to Mariana Mabilog, resident of San Vicente, Dapitan City,
after having been duly sworn to an oath in accordance with law, do hereby depose and
say the following, THAT:

72. We are transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 7144, Pls-460 situated at Pulawan, Dapitan City,
and covered by Original Certificate of Title No.(P-9241)973, containing an area
of 15,877 square meters issued by ROD for Dapitan City”

73. The above stated parcel of land is agricultural land;

74. The area purchased/inherited classified as agricultural land, we warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
75. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
76. We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
77. We are executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcel of land and for titling and whatever legal
purposes this may serve.
 IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

ARNIEL R. LACQUIO ALBERTO P. MABILOG

Affiant Affiant
Valid ID#______ Valid ID#______________

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ARNALDO T. YUAYAN, of legal age, Filipino, married, a resident of

San Roque, Zamboanga City, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

1. I am a member of the Armed Forces of the Philippines;

2. I was the holder of the licensed firearm bearing the following details:
Make: ARMSCOR; Caliber: .45MM; Serial No.:1193221;

3. I declared the said firearm lost after I lost it and executed an affidavit of
loss to support my declaration;

4. I hereby attest that the undersigned and the said firearm are not involved, in
any manner, in any criminal investigation and has no pending criminal,
civil or administrative cases;

5. I am executing this affidavit to attest to the truth of the foregoing statements

and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2024, at Dipolog City, Philippines.

ARNALDO T. YUAYAN
(Affiant)
AFP Enlisted Personnel ID#PN-EP-12983
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________

2024, at Dipolog City.
DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, DEREK R. TAROY, of legal age, Filipino, single, a resident of East Fairview,

Quezon City, Manila, after having been duly sworn to an oath in accordance with law,
do hereby depose and state, that:

6. I am the representative and employee of A.A. Alarilla Cons. Co. Inc.;

7. My employee intends to transport and bring several telecommunications

equipment at the Linabo Peak, Lugdungan, Dipolog City for GMA 7 Network;

8. The equipment we intend to bring have considerable weight that might affect or
might destroy the stairs and railings going to the Linabo Peak, owned by the City
Government of Dipolog City;

9. Considering the effect of these equipment to the property of City Government of

Dipolog City, I hereby undertake to repair and restore all the properties of the
government that might be affected during the transport of the equipment going to
the Linabo Peak;

10. The said transport activity also shall not affect the normal operations of the said
Linabo Peak and its residents;

11. I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

DEREK A. TAROY
(Affiant)
Valid ID#0196508
With photo
 SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at
Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CONCORDIO SARA DAYMIEL,JR, of legal age, Filipino, single, a resident

of Sicayab, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and state, that:

26. I am currently employed at Zamboanga del Norte Medical Center by

Provincial Government of Zamboanga del Norte;
27. My salaries and benefits covering August 2022-March 2024 are not yet
released due to non-submission of my Daily Time Record;
28. The reason for non-submission is my health condition during that time
worsen;
29. As result, all my mandatory remittances to GSIS, Pag-ibig, Philhealth and to
others including loan amortizations, were not paid timely;
30. I have now submitted all my requirements and in view thereof, I hereby
undertake to pay including government share to all my mandatory remittances
to be deducted from salaries and benefits including all arrears thereon;
31. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

CONCORDIO SARA DAYMIEL,JR

(Affiant)
Valid ID#___________________________
With photo
 SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at
Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JAY BOLANDO REDILLAS-PILA, of legal age, Filipino, married, a resident

of Gulayon, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

32. I completed the academic requirements for a Masteral degree and units of
Doctor of Educational Management, a post graduate course, with the Saint
Vincent’s College, Inc-Dipolog City;

33. I processed for the Honorable Dismissal and other papers in furtherance of my
academic profession with Mandaue City College in Mandaue City;

34. I received my relative documents from Saint Vincent’s College, Inc;

35. I did submit the pertinent papers like the Honorable Dismissal and others to
the said Mandaue City College as I handcarried it but I did not pursue my
studies in the said college;

36. Saint Vincent’s College, Inc. was not able to release the pertinent documents
because Mandaue City College did not follow up for its transfer;

37. I would like to retain all my credentials, papers and other school records with
Saint Vincent’s College, Inc.-Dipolog City;
 38. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

JAY BOLANDO REDILLAS-PILA

(Affiant)
UMID ID#CRN-006-0173-8035-9
With photo

SUBSCRIBED AND SWORN to before me using her document of identity as

shown above as proof of identification this __th day of _________ 2024, at Dipolog City.

[Link].
PAGE NO.
BOOK NO.
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: JAY BOLANDO REDILLAS-PILA, of legal age, Filipino, married, a

resident of Gulayon, Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Isuzu Color: Silver

Plate No.:GSE178 Series: Elf

That the said vehicle owned by undersigned was impounded after it was
involved in a vehicular accident that happened on April 24, 2024 at about 11 in the
morning at Bypass Road, Barangay Sinaman, Dipolog City wherein the
abovementioned motor vehicle met an accident another motor vehicle;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That as of this writing, there is no case filed before the Honorable Court,
hence the said motor vehicle should be released from impoundment;
 That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 25th

day of April 2024, at Dipolog City, Philippines.

FELIX ZAMORAS MANGUBAT

(Affiant)
OSCA ID#SIB-22-0051
Issued in Sibutad,ZN
With photo

SUBSCRIBED AND SWORN to before me this 25th day of April 2024, at

Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: FELIX ZAMORAS MANGUBAT, of legal age, Filipino, married, a

resident of Kanim, Sibutad, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Isuzu Color: Silver

Plate No.:GSE178 Series: Elf

That the said vehicle owned by undersigned was impounded after it was
involved in a vehicular accident that happened on April 24, 2024 at about 11 in the
morning at Bypass Road, Barangay Sinaman, Dipolog City wherein the
abovementioned motor vehicle met an accident another motor vehicle;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;
 That as of this writing, there is no case filed before the Honorable Court,
hence the said motor vehicle should be released from impoundment;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 25th

day of April 2024, at Dipolog City, Philippines.

FELIX ZAMORAS MANGUBAT

(Affiant)
OSCA ID#SIB-22-0051
Issued in Sibutad,ZN
With photo

SUBSCRIBED AND SWORN to before me this 25th day of April 2024, at

Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, STACY G. REYES, of legal age, Filipino, married Junreylu L. Reyes, a

resident of Purok Evergreen Sta. Filomena, Dipolog City, Zamboanga del Norte,
represented by JUNREYLU L. REYES after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

39. I was employed by Zamboanga del Norte Electric Cooperative;

40. I have existing loans with LandBank of the Philippines using my salaries and
benefits at the Zamboanga del Norte Electric Cooperative as security;
41. I have already separated from my employment with Zamboanga del Norte
Electric Cooperative;
42. In view of my separation from employment, I hereby undertake that I will
continue to pay my loan through over-the -counter payment scheme despite
my separation from my current employment;
43. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

STACY G. REYES
 Represented by:

JUNREYLU L. REYES
(Affiant)
Phil. ID#8532-4601-8628-9617
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at

Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF WILLINGNESS TO MAKE LAND PRODUCTIVE

I:EDEN L. REFUGIO, married, of legal age, Filipino, with Philippine residence of

Sibutad, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

1. I am transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 6,Psd-09-026079-AR/VLT situated at Magsaysay,

Sibutad, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.T-5475, containing an area of 19,845 square meters issued by ROD for
Zamboanga del Norte”

2. The I hereby undertake to make the above-said parcel of land productive and
developed;
3. That I am willing to introduce improvements over the said parcel of land;
 4. I am executing this affidavit to attest to the truth of the foregoing statements and
for subdivision of said parcel of land and for titling and whatever legal purposes
this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

EDEN L. REFUGIO
Affiant
PRC ID#0592943

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I:ELMA L. ELLIOTT, married, of legal age, Filipino, with Philippine residence of

Magsaysay, Sibutad, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

78. I am transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 5,Psd-09-026079-AR/VLT situated at Magsaysay,

Sibutad, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.T-5474, containing an area of 19,845 square meters issued by ROD for
Zamboanga del Norte”

79. The above stated parcel of land is agricultural land;

80. The area purchased/inherited classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
81. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
 82. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents I
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
83. I am executing this affidavit to attest to the truth of the foregoing statements and
for subdivision of said parcel of land and for titling and whatever legal purposes
this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

ELMA L. ELLIOT
Affiant
[Link]:

EDEN L. REFUGIO
Attorney-in-fact
PRC ID#0592943

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: SERENA B. PERAS, minor, represented by mother EVELYN S. BARTE-PERAS,

married, of legal age, Filipino, all with Philippine residence of Estaka, Dipolog City,
Zamboanga del Norte, after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

84. I am transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 2-B, CSD-09-07-000997 situated at Diculom,

Balguian, Zamboanga del Norte, and covered by Original Certificate of Title
No.P-28161, containing an area of 49,995 square meters issued by ROD for
Zamboanga del Norte”

85. The above stated parcel of land is agricultural land;

86. The area purchased/inherited classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
87. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
 88. I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents I
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
89. I am executing this affidavit to attest to the truth of the foregoing statements and
for subdivision of said parcel of land and for titling and whatever legal purposes
this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

SERENA B. PERAS
Represented by:

EVELYN S. BARTE-PERAS
Affiant
UAE Drivers License#65728

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: ROMMEL LICAYAN ANTIVO, of legal age, Filipino, single, a resident

of Purok Nipa, Minaog, Dipolog City, Zamboanga del Norte, after having been
duly sworn to an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: Yamaha Color: Blue

Plate No.0701494512 Series: Mio

That the said vehicle driven by undersigned was impounded after it was
involved in a vehicular accident that happened on April 6, 2024 at about 4:40 in
the morning at Barangay Estaka, Dipolog City near the Quezon Bridge wherein
the abovementioned motor vehicle met an accident another motor vehicle;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;
 That as of this writing, there is no case filed before the Honorable Court,
hence the said motor vehicle should be released from impoundment;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 16th

day of April 2024, at Dipolog City, Philippines.

ROMMEL LICAYAN ANTIVO

(Affiant)
Phil ID#6529-3473-6089-6375
With photo

SUBSCRIBED AND SWORN to before me this 16th day of April 2024, at

Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: SPOUSES CARL EDWARD C. PANORIL and KATHLEEN MAE B.

PANORIL, both of legal age, both Filipinos, both residents of Poblacion North, Polanco,
Zamboanga del Norte, after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

90. We are the transferees of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 3191-C-4-C situated at Polanco, Zamboanga del

Norte, and covered by Transfer Certificate of Title No.T-81854, containing an
area of 6,165 square meters issued by ROD for Zamboanga del Norte”

91. The above stated parcel of land is agricultural land;

92. The area purchased/inherited classified as agricultural land/s, we warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
93. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
 filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
94. We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
95. We are executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcels of land and for titling and whatever legal
purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

CARL EDWARD C. PANORIL KATHLEEN MAE B. PANORIL

(Affiant ) (Affiant)
Valid ID#_____________ Valid ID#_______________
With photo With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: LEODENILO H. MAGCANTA, of legal age, Filipino, married, a

resident of San Roque, Rizal, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Mitsubishi Series:Dropside

Engine No.:4DR7-873636 Chassis No.:FB308A-540546
Plate No.GSP473 Color:Green

That the said vehicle driven by undersigned was impounded after it was
involved in a vehicular accident that happened on February 22, 2024 at about 6:30
in the evening along provincial road at Purok 2, Brgy. San Roque, Rizal,
Zamboanga del Norte wherein the abovementioned motor vehicle met an accident
another motor vehicle;
 That as result my above mentioned vehicle was impounded by the
Philippine National Police of Rizal, Zamboanga del Norte;

That as of this writing, there is no case filed before the Honorable Court,
hence the said motor vehicle should be released from impoundment;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 26th

day of February 2024, at Dipolog City, Philippines.

LEODENILO H. MAGCANTA
(Affiant)
Drivers License#J01-17-002543 valid until 2032/03/04
With photo

SUBSCRIBED AND SWORN to before me this 26th day of February

2024, at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, ELIZABETH S. SALE, married, of legal age, Filipino, and residing at

Morob, Leon B. Postigo, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

1. I am the PUNONG BARANGAY of BARANGAY MOROB, LEON B.

POSTIGO, ZAMBOANGA DEL NORTE which will be celebrating its Araw
 ng Morob that will start on March 14-15, 2024 at Morob, Leon B. Postigo,
Zamboanga del Norte and in connection with the latter, I received an amount
of CASH DONATION amounting to TEN THOUSAND(P10,000.00)PESOS
as Financial Assistance for Araw ng Morob Celebration from the
PROVINCIAL GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-
ZN)
2. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
3. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

ELIZABETH S. SALE
Affiant
Brgy Morob, [Link],ZN ID#097226018-1
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, EDEN Z. AHIL, married, of legal age, Filipino, and residing at Mucas,
Salug, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and say the following, THAT:

4. I am the PUNONG BARANGAY of BARANGAY MUCAS, SALUG,

ZAMBOANGA DEL NORTE which will be celebrating its 44 th Araw ng
Mucas that will start on March 4-6, 2024 at MUCAS, SALUG, Zamboanga
del Norte and in connection with the latter, I received an amount of CASH
DONATION amounting to TEN THOUSAND(P10,000.00)PESOS as
Financial Assistance for 44th Araw ng Mucas Celebration from the
PROVINCIAL GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-
ZN)
5. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
6. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

EDEN Z. AHIL
Affiant
Drivers License#J07-20-013492 valid until 2025/05/29
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I: DEMETRIO HAMOY BUSTALIǸO,JR, married;of legal age, Filipinos, with

Philippine residence of San Roque, Rizal, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

96. I am transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 437-D,Psd-218387 situated at San Roque, Rizal,

Zamboanga del Norte, and covered by Transfer Certificate of Title No.T-44141,
containing an area of 44,288 square meters issued by ROD for Zamboanga del
Norte”

97. The above stated parcel of land is agricultural land;

98. The area purchased/inherited classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other uses
or purposes;
99. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
100. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
101. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

DEMETRIO HAMOY BUSTALIǸO,JR.

Represented by:

JOSE JOVEN C. RICONALLA

(Affiant)
Valid ID#__________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, QUINTIN C. PATOC,JR, married, of legal age, Filipino, and residing at
San Juan, Gutalac, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

7. I am the PUNONG BARANGAY of BARANGAY SAN JUAN, GUTALAC,

ZAMBOANGA DEL NORTE which will be celebrating its Araw ng San Juan
that will start on February 12-14, 2024 at San Juan, Gutalac, Zamboanga del
Norte and in connection with the latter, I received an amount of CASH
DONATION amounting to TEN THOUSAND(P10,000.00)PESOS as
Financial Assistance for Araw ng San Juan Celebration from the
PROVINCIAL GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-
ZN)
8. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
9. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

QUINTIN C. PATOC,JR
Affiant
Drivers License#J01-16-000854
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I: RICHIE NEMAR Z. BATION, married, of legal age, Filipino, and

resident of Dicayas, Dipolog City, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say the following, THAT:

102. I am an applicant for renewal of businee permit over my business

with name RICHIE NEMAR Z. BATION GASOLINE STATION, located
at Lalawan, Dicayas, Dipolog City;
103. The nature of business is trading of gasoline products;
104. One of the requirements of my business is a Certificate of Compliance
issued by Department of Energy;(DoE)
105. In year 2023, I was issued by DoE my Certificate of Compliance;
106. I have a pending application for renewal of my said Certificate of
Compliance from DoE;
107. In view of the renewal of my business permit, I hereby undertake to renew
my Certificate of Compliance from DoE this year;
108. That should I fail to comply with this undertaking, the business permit
relative thereto shall automatically and immediately be revoked or cancelled
without any need for notice and hearing by the City Government of Dipolog City.
109. I hereby absolve from any liability the officers and employees of
Licensing and Permits Division of LGU Dipolog City relative to above stated
transaction and release of pertinent permit/document;
110. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

RICHIE NEMAR Z. BATION

(Affiant)
PRC ID#0019445-Electronics Engineer
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I: IRIS C. BAKER, of legal age, Filipino, married to Paul Edward

Baker(American), resident of Anastacio, Polanco, Zamboanga del Norte rep by
ELIZTER C. SALUDAR, after having been duly sworn to an oath in accordance with
law, do hereby depose and say the following, THAT:

111. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 2984-D-2-A, Psd-09-047185 situated at

Anastacio, Polanco, Zamboanga del Norte, and covered by Transfer Certificate
of Title No.T-84085, containing an area of 3,685 square meters issued by ROD
for Zamboanga del Norte”
112. The above stated parcel of land is agricultural land;
113. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
114. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
115. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
116. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

IRIS C. BAKER
[Link]:

ELIZTER C. SALUDAR
Attorney-in-fact
Phil ID#6473-8431-8971-2690

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: SPOUSES ROGELIO Y. CORSAME,JR and MARLINIE CRISTINE J.

CORSAME, both of legal age, both Filipinos, both residents of Zone 2 Culianan,
Zamboanga City, after having been duly sworn to an oath in accordance with law, do
hereby depose and say the following, THAT:

117. We are the transferees of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 2297,Pls-29(Philcusa-Foa) situated at Dipane,

Manukan, Zamboanga del Norte, and covered by Original Certificate of Title
No.P-7024, containing an area of 235,605 square meters issued by ROD for
Zamboanga del Norte”

118. The above stated parcel of land is agricultural land;

119. The area purchased/inherited classified as agricultural land/s, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
120. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
121. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
122. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

ROGELIO Y. CORSAME,JR MARLINIE CRISTINE J. CORSAME

(Affiant ) (Affiant)
Valid ID#_____________ Valid ID#_______________
With photo With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No.
Page No.
Book No.
Series of 2024

That I: IRIS C. BAKER, of legal age, Filipino, married to Paul Edward

Baker(American), resident of Anastacio, Polanco, Zamboanga del Norte
rep by ELIZTER C. SALUDAR, after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

I am the transferee of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 2984-D-2-A, Psd-09-047185

situated at Anastacio, Polanco, Zamboanga del Norte, and
covered by Transfer Certificate of Title No.T-84085, containing an
area of 3,685 square meters issued by ROD for Zamboanga del
Norte”

Complying with the provisions of Section 70 of Republic Act. No. 6657 (CARP), I
hereby declare, by these presents, that my total aggregate landholdings and that of said
land do not exceed more than five (5) hectares;

The said land is not tenanted and only use and utilize by immediate family members;

The land is not subject to any case or there is no pending case before DAR, DARAB,
Office of the President or any other tribunal or courts involving the said parcel of land;

ACCORDINGLY, I am executing this affidavit to attest to the truth of the foregoing and
in support of my/our intention to register the documents of transfer in favor of another
and to form part of compliance with legal requirements of the Registry of Deeds for
Dipolog City/Dapitan City/Zamboanga del Norte and the Agrarian Reform Law of the
Philippines.

IN WITNESS WHEREOF I have hereunto affixed my signaturess this ____ day

of _______ 2024, at Dipolog City.

IRIS C. BAKER
[Link]:

ELIZTER C. SALUDAR
Attorney-in-fact
Phil ID#6473-8431-8971-2690

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, ALLAN [Link], married, of legal age, Filipino, and residing at

Seres, Katipunan, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:
 10. I am the PUNONG BARANGAY of BARANGAY SERES, KATIPUNAN,
ZAMBOANGA DEL NORTE which will conduct Basketball Tournament for
the 60th Founding Anniversary of Seres, Katipunan, Zamboanga del Norte on
February 9, 2024 at Seres, Katipunan, Zamboanga del Norte and in connection
with the latter, I received an amount of CASH DONATION amounting to
TEN THOUSAND(P10,000.00)PESOS as Financial Assistance for the
Basketball Tournament of the 60th Founding Anniversary of Seres, Katipunan,
Zamboanga del Norte from the PROVINCIAL GOVERNMENT OF
ZAMBOANGA DEL NORTE(PGO-ZN)
11. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
12. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2024, at Dipolog City, Philippines.

ALLAN O. JALOSJOS
Affiant
Philippine ID#3865-7605-8916-9715
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING TO RETURN TO THE PHILIPPINES

I, MICHELLE BATION, of legal age, Filipino, single, a resident of La

Union, La Libertad, Zamboanga del Norte,7119 after having been duly sworn to
an oath in accordance with law, do hereby depose and say:
 That I am applicant for Visit /VISA to visit my fiancée in the Republic of
Poland;

That the name of my fiancée is KRYSTIAN FARYNIARZ, a native of

Poland;

That the intention of my application for VISA is to visit my said fiancée

and meet his family in Poland for twenty(20) days only;

That I hereby undertake that I will return immediately to the Philippines

upon the expiration of my VISA regarding my 20-day visit, without undue delay
and unnecessary cost to the host country;

That I hereby authorize the embassy or any government offices to validate

and verify all information and data submitted by undersigned;

That I attest the truthfulness of foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 25th

day of January 2024, at Dipolog City, Philippines.

MICHELLE BATION
(Affiant)
Philippine ID#2547-2984-5038-7319
With photo

SUBSCRIBED AND SWORN to before me this 25th day of January 2024,

at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: Spouses ABSALON NIDO PORTO,JR and REJIE T. PORTO, both of legal
age, both Filipinos, both residents of Sitog, Katipunan, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:
 123. We are the transferees of parcel of land more particularly described
as follows:

“A parcel of land known as Lot 5017-C-1, CSD-09-009828 situated at Sanao,

Katipunan, Zamboanga del Norte, and covered by Katibayan ng Orihinal na
Titulo Blg. 2018000286, containing an area of 19,567 square meters issued by
ROD for Zamboanga del Norte”

124. The above stated parcel of land is agricultural land;

125. The area purchased/inherited classified as agricultural land/s, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
126. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
127. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
128. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2024, at Dipolog City, Philippines.

ABSALON NIDO PORTO JR REJIE T. PORTO

(Affiant ) (Affiant)
Drivers License#N01-90-106411 TIN#947046625
With photo With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2024, at Dipolog
City.

Doc. No.
Page No.
Book No.
Series of 2024

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NOEL L. ALABAN, of legal age, Filipino, single, a resident of Lower

Gumay, Pinan, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:
 That I am the representative of owner of a motor vehicle, which is more
particularly described as follows;

MAKE: Honda Series:CFT125MRM

Engine No.:KPYV1E017808 Chassis No.:KPYV1017817
Plate No. 473JYK CR No.:47000380-8

That the said vehicle driven by Ronald Griffon was impounded after it was
involved in a vehicular accident that happened on December 24,2023 at about 6:30
in the morning along Poblacion South, Polanco, Zamboanga del Norte wherein the
abovementioned motor vehicle met an accident another motor vehicle;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12th

day of January 2024, at Dipolog City, Philippines.

NOEL L. ALABAN
(Affiant)
Drivers License#J01-23-006336
With photo

SUBSCRIBED AND SWORN to before me this 12th day of January 2024,

at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, FELITA ROMAGUERA ACOYMO, of legal age, Filipino, single, a resident of

Dicayas, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

44. I am currently employed by Provincial Government of Zamboanga del Norte;

45. I intend to transfer my employment at the Philippine Judiciary;
46. I have existing loans with Zamboanga del Norte Cooperative Bank using my
salaries and benefits at the Provincial Government of Zamboanga del Norte as
security;
47. In view of the approval of my transfer of employment, I hereby undertake that
I will continue to pay my loan through over-the -counter payment scheme
despite my transfer from my current employment;
48. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2024, at Dipolog City, Philippines.

FELITA ROMAGUERA ACOYMO

(Affiant)
Phil. ID#5069-3801-9841-058
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2024, at

Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, KHRISTINE G. BINARAO, of legal age, Filipino, single, a resident of

Gulayon, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Honda Series:Beat

Plate No. Temporary Plate #0908-
336648

That the said vehicle driven by undersigned was impounded after it was
involved in a vehicular accident that happened on October 26,2023 at about 8:00
in the evening along Bypass Road, Galas, Dipolog City, Zamboanga del Norte
wherein the abovementioned motor vehicle met an accident another motor vehicle
Rusi motorcycle color blue bearing temporary plate number 1915 SA driven by
Maylin A. Canonigo;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5th

day of January 2024, at Dipolog City, Philippines.

KHRISTINE G. BINARAO
(Affiant)
DSWD 4Ps ID#097202006-0346-0004
With photo

SUBSCRIBED AND SWORN to before me this 5th day of January 2024,

at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF CONSENT

I: CITY GOVERNMENT OF DIPOLOG represented by: HON.

DAREL DEXTER T. UY, of legal age, Filipino, married, and resident of Dipolog
City, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

129. The City Government of Dipolog is a co-owner of parcel of

land covered by TCT No.128-2023000204 located at Turno, Dipolog
City with a total area of 1,108 square meters
130. A portion of 1,065 square meters owned by Alano & Sons
Credit Corporation was sold to ZABDIEL KHATE ABING as
evidenced by Deed of Absolute Sale notarized by Atty Karen Sy
Tindugan-Perez per Doc. No.591, Page No.15, Book No.2, Series of
2022;
131. A portion of 43 square meters is owned by the City
Government of Dipolog;
132. The City Government of Dipolog City hereby gives consent in
the said sale in favor of ZABDIEL KHATE ABING by Alano &
Sons Credit Corporation;
133. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of ___________2023, at Dipolog City, Philippines.

CITY GOVERNMENT OF DIPOLOG:

Represented by:

HON. DAREL DEXTER T. UY

City Mayor
(Affiant)
 Valid ID#________________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at

Dipolog City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF SOURCE OF FUNDS

I: MELUDY R. ABING, single, of legal age, Filipino, and resident of

Lower Dicayas, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following, THAT:

134. I am the mother ZABDIEL KHATE ABING, a minor;

135. My said child is the vendee in a Deed of Absolute Sale notarized by
Atty Karen Sy Tindugan-Perez per Doc. No.591, Page No.15, Book No.2,
Series of 2022 involving TCT No.128-2023000204 located at Turno,
Dipolog City;
136. The source of money for the purchase over the said parcel of land
came from the undersigned;
137. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.
 MELUDY R. ABING
(Affiant)
Driver’s License#J01-17-003977
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:JOHN RICKY POYOS UBAG, of legal age, single, Filipino, resident of Pian,
Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

138. I am the accused in the case titled People of the Philippines vs. JOHN
RICKY POYOS UBAG with Criminal Case No.26782 pending before Regional
Trial Court-Branch 6, Dipolog City, Ninth Judicial Region;
139. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
140. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
141. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve
 IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of
December 2023, at Dipolog City, Philippines.

JOHN RICKY POYOS UBAG

(Affiant)
Valid ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of December 2023, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: JULIUS R. DIVINAGRACIA, married, of legal age, Filipino, and

resident of [Link], Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

142. I am the representative of WYT CONSTRUCTION AND

DEVELOPMENT CORP;
143. WYT CONSTRUCTION AND DEVELOPMENT CORP. is the
contractor of Road Concreting for Barangay Daro, Dapitan City of the
LGU-Dapitan City;
144. Part of the requirement project is the Material Testing Result, which
was commissioned by the contractor with Provincial Government of
Zamboanga del Norte
145. All activities were done already for the issuance of issuance of Material
Testing Result.
 146. In view thereof, I undertake to submit immediately to the LGU-Dapitan
City once the Material Testing Result is released;
147. I hereby absolve from any liability the officers and employees of LGU-
Dapitan City relative to above stated transaction and release of pertinent
permit/document;
148. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of the release of the progess billing and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

JULIUS R. DIVINAGRACIA
(Affiant)
Phil ID#6192-0573-1409-1290
With photo
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: CARLITO L. ORTEGA, married, of legal age, Filipino, and resident of

Estaka, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

149. I am the proprietor of STARS AND STRIPES CONSTRUCTION;

150. STARS AND STRIPES CONSTRUCTION is the contractor of
Construction of Two(2) Storey(7.30m x 10.80m)Multi-purpose
Building at Brgy Sto. Tomas, Mutia, Zamboanga del Norte of the LGU-
Zamboanga del Norte;
 151. Part of the requirement project is an approved Construction Safety
and Health Program(CSHP) by Department of Labor and
Employment(DOLE);
152. STARS AND STRIPES CONTRUCTION has already submitted the
documents to DOLE for approval.
153. In view thereof, I undertake to submit immediately to the LGU-
Zamboanga del Norte once the DOLE approved CSHP document is released;
154. I hereby absolve from any liability the officers and employees of LGU-
Zamboanga del Norte relative to above stated transaction and release of pertinent
permit/document;
155. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of the release of the progess billing and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

CARLITO L. ORTEGA
(Affiant)
Valid ID#______________________
With photo
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:JOSE JORANDE GANIA LEGADOS, of legal age, married, Filipino, resident

of Purok Daisy, Dansullan, Polanco, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:
 156. I am the accused in the case titled People of the Philippines vs. JORANDE
GANIA LEGADOS with Criminal Case No.___________ pending before
Regional Trial Court Branch _____, Ninth Judicial Region;
157. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
158. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
159. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

December 2023, at Dipolog City, Philippines.

JOSE JORANDE GANIA LEGADOS

(Affiant)
Valid ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of December 2023, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:JOHN RICKY POYOS UBAG, of legal age, single, Filipino, resident of Pian,
Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

160. I am the accused in the case titled People of the Philippines vs. JOHN
RICKY POYOS UBAG with Criminal Case No.26782 pending before Regional
Trial Court-Branch 6, Dipolog City, Ninth Judicial Region;
161. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
 against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
162. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
163. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

December 2023, at Dipolog City, Philippines.

JOHN RICKY POYOS UBAG

(Affiant)
Valid ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of December 2023, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JESUS L. MOCOY, of legal age, Filipino, married, a resident of

Lugdungan, Dipolog City, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Skygo Plate No.:090109

Engine No.:1P52FMIL1058847 Chassis No.LX8XCJTB4LA002713

That the said vehicle driven by undersigned was impounded after it was
involved in a vehicular accident that happened on November 28,2023 at about
6:36 in the evening along Kagatan Road, Sta. Isabel, Dipolog City, Zamboanga del
Norte wherein the abovementioned motor vehicle met an accident another motor
vehicle Mitsubishi Montero with Plate Number KAF 1445;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 1 st

dayday of December 2023, at Dipolog City, Philippines.

JESUS LARANJO MOCOY

(Affiant)
DSWD 4Ps ID#097202006-0346-0004
With photo

SUBSCRIBED AND SWORN to before me this 1st day of December 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ROMELYN O. TALAROC, of legal age, Filipino, single, a resident of

Santo Tomas, Mutia, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: Honda CR NO.:47003321-1

Engine No.:KPYV2E012797 Chassis No.:KPYV2012719
Plate Number:907JYN SERIES:CFT125MRCM

That the said vehicle driven by undersigned’s father Romeo Cagatan

Talaroc was impounded after it was involved in a vehicular accident that happened
on October 16,2023 at about 12:27 in the afternoon along junction road of Brgy.
Sto Tomas, Mutia, Zamboanga del Norte wherein the abovementioned motor
vehicle met an accident another motor vehicle Honda Beat Red/White
Combination with CR No.282712640 registered in the name of Ailen Grace B.
Balagon;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Mutia, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor together with its accessories with the undertaking that I shall make the
same available to the Honorable Prosecutor, Philippine National Police, or any
authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ th

day of November 2023, at Dipolog City, Philippines.

ROMELYN O. TALAROC
(Affiant)
Drivers License#J01-11-002663 valid until 2032/06/19
With photo

SUBSCRIBED AND SWORN to before me this __th day of November

2023, at Dipolog City with evidence of identity as shown above.

Doc. No.________
Page No._________
Book No.____________
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, VICTORINO BENITEZ BELANGDAL, of legal age, Filipino, single,

a resident of San Pedro, Polanco, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: Hyundai COLOR:White

Plate Number:KCB174 SERIES:Coupe
 That the said vehicle was impounded after it was involved in a vehicular
accident that happened on May 30,2023 at about 8:46 in the evening along
National Highway at Brgy New Sicayab, Polanco, Zamboanga del Norte wherein
the abovementioned motor vehicle met an accident another motor vehicle Honda
Beat bearing plate number 090102, Engine No.JF78E7290703, Chassis
No.K81N1023932;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Polanco, Zamboanga del Norte together with the
undersigned driver’s license with number J01-94-017731,key, Official Receipt and
motor vehicle’s certificate of registration;

That I hereby request for the release of the said motor vehicle registered in
my favor together with driver’s license card,key, Official Receipt and certificate of
registration of motor vehicle with the undertaking that I shall make the same
available to the Honorable Prosecutor, Philippine National Police, or any authority
in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 20 th

day of October 2023, at Dipolog City, Philippines.

VICTORINO BENITEZ BELANGDAL

(Affiant)
PNP ID#PRO9-7R210-130537675
With photo

SUBSCRIBED AND SWORN to before me this 20th day of October 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.1708
Page No.51
Book [Link]
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF ALLOWANCE TO MARRY

We:JOSE GADFRE C. GERVABUENA and MARIA FE M. SUASULA, both

of legal age, both Filipinos, residents of Estaka, Dipolog City and Miputak, Dipolog City,
respectively,after having been duly sworn to an oath in accordance with law, do hereby
depose and state, that:

164. We are parties in contract of marriage that will be celebrated in Dipolog

City;
165. We have already complied all the essential and formal requisites to enter a
contract of marriage;
 166. We secure marriage licenses at Local Government of Dipolog City;
167. We hereby attest that we are allowed to celebrate and conduct the
ceremony of marriage before a person duly licensed to contract marriage at any
place other than the place of worship provided the celebration is made within the
territorial jurisdiction;
168. We are executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of October 2023, at Dipolog City, Philippines.

JOSE GADFRE [Link]

(Affiant)
Philippine Passport No.P4632284B
With photo

MARIA FE M. SUASULA
(Affiant)
Philippine Passport No. P6975090A
With photo

SUBSCRIBED AND SWORN to before me this __th day of October 2023, at

Dipolog City.

Doc. No.
Page No
Book No
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, PAQUITO C. SEVILLA, of legal age, Filipino, married, a resident of

Punta, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

49. I am currently employed by Provincial Government of Zamboanga del

Norte with position of Heavy Equipment Operator I;
50. I intend to retire from service effective January 2, 2024;
51. I have an existing loan with Landbank of the Philippines in the amount
of P20,569.71, as of this writing;
52. I utilize my employment as security on my said application for loan;
53. I hereby undertake that I will pay my loan immediately with Landbank
of the Philippines using the proceeds of my Terminal Leave
Benefits(TLB) after I retire;
54. In the event I will not comply with this undertaking, I hereby authorize
the said bank to claim whatever balance of the obligation incurred from
my remaining claims at Provincial Government of Zamboanga del Norte
and/or other sources of obligation;
55. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2023, at Dipolog City, Philippines.

PAQUITO C. SEVILLA
(Affiant)
OSCA ID#17367-Dipolog City
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________

2023, at Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, VICTORINO BENITEZ BELANGDAL, of legal age, Filipino, single,

a resident of San Pedro, Polanco, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: Hyundai COLOR:Black

ENGINE NO.:E3W7E0046818 CHASSIS NO.:PA0RE3210H0046033
Plate Number:090806 SERIES:Coupe

That the said vehicle was impounded after it was involved in a vehicular
accident that happened on May 30,2023 at about 8:46 in the evening along
National Highway at Brgy New Sicayab, Polanco, Zamboanga del Norte wherein
the abovementioned motor vehicle met an accident another motor vehicle Honda
Beat bearing plate number 090102, Engine No.JF78E7290703, Chassis
No.K81N1023932;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor with the undertaking that I shall make the same available to the
Honorable Prosecutor, Philippine National Police, or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

VICTORINO BENITEZ BELANGDAL

(Affiant)
PNP ID#PRO9-7R210-130537675
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.
Page No.
Book No
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, PAQUITO C. SEVILLA, of legal age, Filipino, married, a resident of

Punta, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

56. I am currently employed by Provincial Government of Zamboanga del

Norte with position of Heavy Equipment Operator I;
57. I intend to retire from service effective January 2, 2024;
58. I have an existing loan with Zamboanga del Norte Cooperative Bank in
the amount of P38,000.00;
59. I utilize my employment as security on my said application for loan;
60. I hereby undertake that I will pay my loan immediately with Zamboanga
del Norte Cooperative Bank using the proceeds of my Terminal Leave
Benefits(TLB) after I retire;
61. In the event I will not comply with this undertaking, I hereby authorize
the said bank to claim whatever balance of the obligation incurred from
my remaining claims at Provincial Government of Zamboanga del Norte
and/or other sources of obligation;
62. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2023, at Dipolog City, Philippines.

PAQUITO C. SEVILLA
(Affiant)
OSCA ID#17367-Dipolog City
With photo
 SUBSCRIBED AND SWORN to before me this __th day of _________
2023, at Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, EDGAR T. PARTOSA, married, of legal age, Filipino, and residing at

Raba, Godod, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

13. I am the PUNONG BARANGAY of BARANGAY RABA, GODOD,

ZAMBOANGA DEL NORTE which will conduct Basketball/Volleyball
Tournament and False Gay Contest for the Araw ng Brgy Raba, Godod,
Zamboanga del Norte 2023 Celebration on October 19-21, 2023 at Raba,
Godod, Zamboanga del Norte and in connection with the latter, I received an
amount of CASH DONATION amounting to TEN
THOUSAND(P10,000.00)PESOS as Financial Assistance for the
Basketball/Volleyball Tournament and False Gay Contest for the Araw ng
Brgy Raba, Godod, Zamboanga del Norte 2023 Celebration from the
PROVINCIAL GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-
ZN)
14. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
15. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.
 EDGAR T. PARTOSA
Affiant
PWD ID#09-7225-012-044
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JADE A. LEOPOLDO, of legal age, Filipino, single, a resident of

Poblacion South, Polanco, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: Yamaha COLOR:Black

ENGINE NO.:E3W7E0046818 CHASSIS NO.:PA0RE3210H0046033
Plate Number:090806

That the said vehicle was impounded after it was involved in a vehicular
accident that happened on October 9,2023 at about 6:46 in the eveing along
National Highway at Brgy Gulayon, DIpolog City wherein the abovementioned
motor vehicle met an accident another motor vehicle Honda XRM 125 color
black/white bearing temporary plate number 0901-141421, No OR/CR driven by
Mr. Vince Cyrus P. Bas;
 That as result my above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor with the undertaking that I shall make the same available to the
Honorable Prosecutor, Philippine National Police, or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

JADE A. LEOPOLDO
(Affiant)
LTO Drivers License#J01-06-001208
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ANGEL C. GUMANTASON, of legal age, Filipino, single, a resident

of Olingan, Dipolog City, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: Honda COLOR:Red

Plate Number:0908-3386199

That the said vehicle was impounded after it was involved in a vehicular
accident that happened on September 23,2023 at about 10:10 in the morning along
bypass road at Brgy Sinaman, DIpolog City wherein her backrider(pillion rider)
got injured in the accident;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;
 That I hereby request for the release of the said motor vehicle registered in
my favor with the undertaking that I shall make the same available to the
Honorable Prosecutor, Philippine National Police, or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

ANGEL C. GUMANTASON
(Affiant)
JRMSU School ID#KC-23-A-00764
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CRISAN S. GUMALES, of legal age, Filipino, single/married, a

resident of New Lebangon, Polanco, Zamboanga del Norte, after having been
duly sworn to an oath in accordance with law, do hereby depose and say:

That I am the representative of Real Motors, seller of a motor vehicle in

installment basis, which is more particularly described as follows;

MAKE: Honda SERIES: CFT125MSL

CHASSIS NO.:KPYT0003738 ENGINE NO.:KPYT0E003742

That the said vehicle was impounded after its possessor Jimboy Galleposo
was arrested for violation of RA 9165;

That the case is docketed as Criminal Case No.26138 at RTC Branch 9,

Dipolog City;

That the said motor vehicle was not included as evidence of prosection and
thus it is still under disposal of the Prosecutor’s Office.
 Thatin view of foregoing I hereby request for the release of the said motor
vehicle registered in my favor with the undertaking that I shall make the same
available to the Honorable Prosecutor, Philippine National Police, or any authority
in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

CRISAN S. GUMALES
(Affiant)
Driver’s License#J01-17-000046
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, AILYN INTES ALIA, single, of legal age, Filipino, and residing at
Barangay Nanginan, Katipunan, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say the following, THAT:

16. I am the mother of Finn Vincent Alia who is a patient of Dr. Norwina Visaya-
Atilano, a Physician;
17. The said Finn Vincent Alia expired at the hospital with professional care of
Dr. Norwina Visaya-Atilano;
18. The amount of professional fee of Dr. Norwina Visaya-Atilano is P15,000.00
however the undersigned could not pay the former;
 19. I shall undertake to pay Dr. Norwina Visaya-Atilano the amount of
P15,000.00 in two(2) monthly installments:in November 2023 the amount of
P7,500.00 and December 2023 the amount of P7,500.00;
20. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

AILYN INTES ALIA

Affiant
Valid ID#_____________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF JUSTIFICATION

I, LORENA B. DUNQUE, of legal age, Filipino, a resident of

Labrador, Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

63. I am the authorized representative of JOLE REFRIGERATION AND

AIRCONDITIONING SERVICES, with address of Dipolog City;
64. JOLE REFRIGERATION AND AIRCONDITIONING SERVICES is a
registered employer at the Pag-ibig;
65. As employer, JOLE REFRIGERATION AND AIRCONDITIONING
SERVICES is authorized to withhold and remit contributions with Pag-ibig;
66. For the months of January 2021-October 2023, JOLE REFRIGERATION
AND AIRCONDITIONING SERVICES had not remitted with the Pag-ibig
the contributions of former’s employees including the employer’s share
 amounting to total amount of P5,966.00 penalty due to the economic setback
caused by COVID-19 pandemic;
67. However, JOLE REFRIGERATION AND AIRCONDITIONING SERVICES
intend to avail the penalty condonation program/policy of Pag-ibig on the
lapse contributions of employer;
68. With these, JOLE REFRIGERATION AND AIRCONDITIONING
SERVICES will comply with the rules and regulations set by Pag-ibig and
faithfully comply its monthly obligations with Pag-ibig
69. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

LORENA B. DUNQUE
(Affiant)
Valid ID#___________________

SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at

Dipolog City.

DO. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF CIVIL STATUS

I, JOSE PAOLO B. CRUZ, of legal age, Filipino, single, a resident of

Obay, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

70. I am the transferee/ owner of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 875,Pls-5(HV75037),situated at Barangay

Buenasuerte, Piǹan(now Mutia), Zamboanga del Norte, and covered by Original
Certificate of Title No.P-3895, containing an area of (29,658) square meters
71. The above stated parcel of land is agricultural land;
72. The area purchased/inherited classified as agricultural land, I warrant not to
change the actual use of the property from agricultural land use to some other
uses or purposes;
73. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
 filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
74. I fully understand that any violation of the use of the land or any falsification
or misrepresentation of the information herein stated and in the documents I
submitted shall subject us to actions by filing of the appropriate civil, criminal
and/or administrative complaint against me.
75. I am executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcel of land and for titling and whatever legal
purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2023, at Dipolog City, Philippines.

JOSE PAOLO B. CRUZ

(Affiant)
Driver’s License#J01-08-001888
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________

2023, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, NELBERT B. PANANGITAN, single, of legal age, Filipino, and
residing at Caracol, Salug, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

21. I am the Tourism Officer-Designate of LGU of SALUG, ZAMBOANGA

DEL NORTE which will conduct 63rd Celebration of the Municipaly’s
Foundation on September 14-18, 2023 at Salug, Zamboanga del Norte and in
connection with the latter, I received an amount of CASH DONATION
amounting to FIFTY THOUSAND(P50,000.00)PESOS as Financial
Assistance for the 63rd Celebration of the Municipaly’s Foundation from the
PROVINCIAL GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-
ZN)
22. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
23. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

NELBERT B. PANANGITAN
Affiant
LGU Salug,ZN Tourism Office Employee ID#038-C
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
I, NORBERTO DOYSABAS PENADOS, married, of legal age, resident of Poblacion
South, Polanco, Philippines, a bonafide pensioner of the Philippine National Police,
after being sworn to in accordance with the law, do hereby depose and state that:

a) I am a pensioner of the Philippine National Police/Integrated National Police since

January 1, 2024,with the pension amount of
______________________________________Philippine currency;

b) Consistent with the requirements of the Philippine National Police Retirement and
Benefits Administration Service (PRBS), I hereby bind and oblige myself to update
my retirement records during my birth month;

c) In case of physical incapacity, illness or medical condition which will prevent my

person from performing the aforestated obligation, I hereby appoint and constitute
my daughter __SHANAYA NORDANE S. PENADOS as my lawful attorney-in-fact to
transact business relating to my status as a PNP/INP pensioner with PRBS;

d) Consistent with the intent embodied in this instrument, my designated attorney-in-

fact shall inform the PRBS of any circumstances that will happen to my person.
Further they will be the custodian of my pension ATM Card and passbook account
with the obligation of managing the same with due regard to its nature as
government funds and subsequent civil and criminal liabilities under the pertinent
provisions of the New Civil Code of the Philippines and Republic Act 8484;

e) Further, I hereby acknowledge the authority of the PNP to place my pension

account on “tag and hold” status in the event of my failure to update my retirement
records during the period provided under the rules or non-reporting by my
designated attorney-in-fact of any untoward circumstance that will happen to my
person.

Done this ____ day of _______, ______, in Dipolog City, Philippines.

NORBERTO DOYSABAS PENADOS

(Affiant)

Our conformity:
1.__SHANAYA NORDANE S. PENADOS
(Name)
Relationship _Daughter
Contact Number___________________
Complete Address ____________________
2. _________________________
(Name)
Relationship _________________
Contact Number ______________
Complete Address ____________
(N.B. This Affidavit shall not be accepted by PRBS if not notarized)

Sworn and subscribed to before me this ______ day of ________, 2023, Dipolog City, Philippines.
NOTARY PUBLIC
Page No:______
Document No:___
Book No:_____
Series of 2023

AFFIDAVIT OF UNDERTAKING
 That I, DOROTHY B. JARALVE, of legal age, Filipino, married, and resident of
Estaka, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

24. I am a subscriber of Philippine Long Distance Telephone(PLDT) Company

with Account No. 0233384941 at my address in Estaka, Dipolog City;
25. I hereby express my intent to disconnect my subscription from PLDT;
26. I shall undertake to process and comply all requirements and necessary fees
for the completion of the disconnection of my subscription;
27. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

DOROTHY B. JARALVE
Affiant
Voters ID#7202-0041A-I2778DBJ20000
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, ERWIN M. AMBUS, married, of legal age, Filipino, and residing at
Poblacion East, Salug, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

28. I am the BARANGAY KAGAWAD of BARANGAY POBLACION EAST,

SALUG, ZAMBOANGA DEL NORTE which will conduct Basketball
Tournament for the Araw ng Kabataan sa Poblacion East 2023 Celebration on
August 18-20, 2023 at Poblacion East, Salug, Zamboanga del Norte and in
connection with the latter, I received an amount of CASH DONATION
amounting to TEN THOUSAND(P10,000.00)PESOS as Financial Assistance
for the Basketball Tournament for the Araw ng Kabataan sa Poblacion East
2023 Celebration from the PROVINCIAL GOVERNMENT OF
ZAMBOANGA DEL NORTE(PGO-ZN)
29. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
30. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

ERWIN M. AMBUS
Affiant
DILG ID#097213018-08
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, JHONRY S. MANGUMPIT, single, of legal age, Filipino, and residing
at Delucot, Godod, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

31. I am the SK CHAIRPERSON of BARANGAY DELUCOT, GODOD,

ZAMBOANGA DEL NORTE which will conduct Basketball Tournament for
the 51st Araw ng Delucot Celebration on August 23-24, 2023 at Delucot,
Godod, Zamboanga del Norte and in connection with the latter, I received an
amount of CASH DONATION amounting to TEN
THOUSAND(P10,000.00)PESOS as Financial Assistance for the Basketball
Tournament for the 51st Araw ng Delucot Celebration from the PROVINCIAL
GOVERNMENT OF ZAMBOANGA DEL NORTE(PGO-ZN)
32. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
33. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

JHONRY S. MANGUMPIT
Affiant
Philippine ID#4725-0289-4274-8534
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That I, WILFREDO C. REGENCIA, widower, of legal age, Filipino, and
residing at Bandera, Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following, THAT:

34. I am the PUNONG BARANGAY of BANDERA, POLANCO,

ZAMBOANGA DEL NORTE which will conduct Bikini Open during the
ARAW NG BANDERA Celebration on August 22, 2023 at Bandera, Polanco,
Zamboanga del Norte and in connection with the latter, I received an amount
of CASH DONATION amounting to TEN THOUSAND(P10,000.00)PESOS
as Financial Assistance for the Bikini Open during the ARAW NG
BANDERA Celebration from the PROVINCIAL GOVERNMENT OF
ZAMBOANGA DEL NORTE(PGO-ZN)
35. I shall undertake to comply and submit the required documents such as
OFFICIAL RECEIPTS(OR) and other pertinent papers incidental for the
liquidation purposes of the said Financial Assistance given to me after the
conduct of above-said activity;
36. I am executing this Affidavit of Undertaking to attest the truth of the
aforementioned facts and for other legal intents and purposes which this
affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

WILFREDO C. REGENCIA
Affiant
Valid ID#________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, EULALIO A. TEANO, JR, married, resident of Poblacion South,

Polanco, Zamboanga del Norte represented by CECILIA R. ALVARO, of legal age,
Filipino, and residing at Poblacion South, Polanco, Zamboanga del Norte , after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

169. I am the representative of transferee Eulalio A. Teano,Jr, owner of

parcel of land more particularly described as follows:

“A parcel of land known as Lot 6206-A,situated at Barangay Betlehem, Polanco,

Zamboanga del Norte, and covered by Transfer Certificate of Title No.127-
2018000274, containing an area of (20,000) square meters
170. The above stated parcel of land is agricultural land;
171. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
172. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
173. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
174. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

EULALIO A. TEANO,JR
(Buyer)
Represented by:

CECILIA R. ALVARO
Affiant
Valid ID#________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We:1. LILIA ALMIROL ABELLANOSA, of legal age, Filipino, widow, a resident of

New Sicayab, Polanco, Zamboanga del Norte;
[Link] ALMIROL VILLA, of legal age, Filipino, widow, a resident of New Sicayab,
Polanco, Zamboanga del Norte;
[Link] OF ALFONSO ALMIROL namely: ESTRELLA MAATA ALMIROL, widow; IRISH
[Link], single; ANDRE [Link], single; IRENE M. ALMIROL, single; all of legal
age, all Filipinos, all residents of New Sicayab, Polanco, Zamboanga del Norte;
[Link] OF ERLINDA ALMIROL GUIA namely: REYNALDO A. GUIA, single; DANILO A.
GUIA, single; WENDEL A. GUIA, single; ROEL GUIA, single; all of legal age, all Filipinos, all
residents of New Sicayab, Polanco, Zamboanga del Norte;
[Link] LAQUIO TURTUR, single, of legal age, Filipino, resident of New Sicayab, Polanco,
Zamboanga del Norte;
[Link] L. TURTOR, widower, of legal age, Filipino, resident of New Sicayab,
Polanco, Zamboanga del Norte;
[Link]. LANI L. TURTOR, single, of legal age, Filipino, resident of New Sicayab, Polanco,
Zamboanga del Norte;
8. ROMEO L. TURTOR, single, of legal age, Filipino, resident of New Sicayab, Polanco,
Zamboanga del Norte, after having been duly sworn to an oath in accordance with law, do hereby
depose and say the following, THAT:

175. We are the owners of parcels of land more particularly described as

follows:
“A parcel of land known Lot 2, Psd-09-05-000106 located at New Sicayab(then
Dansullan), Polanco, Zamboanga del Norte covered by Transfer Certificate of
Title No.T-26316 containing an area of 50,000 square meters”.
176. The above stated parcel of land is agricultural land;
177. The area purchased/inherited classified as agricultural land, we warrant not to
change the actual use of the property from agricultural land use to some other uses or
purposes;
178. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply documentary requirements
for Land Use Conversion Order, the application of which , to be filed before the DAR,
Regional Office, Zamboanga City/DAR, Central Office, Quezon City
179. We fully understand that any violation of the use of the land or any falsification
or misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
180. We are executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcels of land and for titling and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day of
___________2023, at Dipolog City, Philippines.

LILIA A. ABELLANOSA CONCEPCION A. VILLA

(Heir) (Heir)
Valid ID#_________________ OSCA ID#17809-Polanco,ZN

IRISH ALMIROL/ANDRE ALMIROL /IRENE ALMIROL

(Heirs of Alfonso Almirol)

REYNALDO GUIA/DANILO GUIA/WENDEL GUIA /ROEl GUIA

(Heirs of Erlinda Guia)

Both Represented by:

ENDIE LAQUIO TURTUR ENDIE LAQUIO TURTUR

(Heir and AIF per SPA attached) (Heir)
Philhealth ID#22-000019766-1 Philhealth#22-000019766-1

MA. LANI LAQUIO TURTOR ALEXANDER L. TURTOR

(Heir) (Heir)
Phil ID#6509-6746-8195-3480 Valid ID#_________________

ROMEO L. TURTOR
(Heir)
Valid ID#_______________

SUBSCRIBED AND SWORN to before me with identification document as shown above by

affiant this ___ day of _________ 2023, at Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT

We: NENA N. ABRIGANA, single and ROMULO ABRIGANA, married

to Emerita Recapente; both of legal age, both Filipinos, both residents of
Poblacion Roxas and Patik Katipunan, respectively, of Zamboanga del Norte,
after having been duly sworn to an oath in accordance with law, do hereby depose
and say:

That we are parties of document notarized by Ivo M. Mandantes per Doc.

No.2069, Page No.48, Book No. XIV, Series of 2022;

That the said transaction involved settlement and waiver of parcels of land
covered by OCT No.P-538 located at Diwan, Dipolog City and OCT No.P-7479
located at Mias, Katipunan, Zamboanga del Norte;

That I, Nena A. Abrigana, hereby confirm that my share is only the land
covered by OCT No.P-7479 located at Mias, Katipunan, Zamboanga del Norte and
I waived my share to Romulo Abrigana on parcel of land covered by OCT No.P-
538 located at Diwan, Dipolog City;

That I, Romulo Abrigana, hereby confirm that my share is only the land
covered by OCT No.P-538 located at Diwan, Dipolog City and I waived my share
to Nena Abrigana on parcel of land covered by OCT No.P-7479 located at Mias,
Katipunan, Zamboanga del Norte;

That we attest the truthfulness of foregoing statements.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __

day of _______________ 2023, at Dipolog City, Philippines.

NENA ABRIGANA
 (Affiant)
Valid ID#_________________
With photo

ROMULO ABRIGANA
(Affiant)
Valid ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.
sDoc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, FAUSTO L. CARDONA, of legal age, Filipino, married, a resident of

Maralag, Polanco, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: SUZUKI SERIES: JITNEY

PLATE NO.: JVK 101

That,the said vehicle was involved in a vehicular incident that transpired on

01 July 2023 at around or about 9:00 in the morning along National Highway,
Minaog, Dipolog City with another two(2) motor vehicles Honda Beat;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my favor with the undertaking that I shall make the same available to the
Honorable Prosecutor, Philippine National Police, or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.
 FAUSTO L. CARDONA
(Affiant)
Valid ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City with evidence of identity as shown above.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: MELANIE UY ESPLANA, MELISSA UY TAN-LEH,

HANNALYN UY MENDOZA and HENRICH D. UY, all of legal age, all Filipinos, and
all residents of Galas, Dipolog City, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say the following, THAT:

181. We are the owners of Open Fruits Stand subject for lease over a portion of
covered by Transfer Certificate of Title No.128-2018000180 situated at Galas,
Dipolog City registered under the name MH Top Corporation, which we owned;
182. A portion of an area of the property has encroached a portion which is
intended for road right of way;
183. In view thereof, we undertake to correct the area which encroached the
required setback for road right of way. We further undertake to limit all tenants on
their display of goods or products within the stall area posts and lastly the garbage
and all forms of wastes by end users or tenants shall be properly segregated or
maintained with trash bins in the area;
184. That should we fail to comply with this undertaking, the building permit
and other permits relative thereto shall automatically and immediately be revoked
or cancelled without any need for notice and hearing in relation to Section 306 of
PD 1096 providing for the grounds for the non-issuance, suspension/revocation of
building permits.
185. we hereby absolve from any liability the officers and employees of Office
of Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
186. We are executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2023, at Dipolog City, Philippines.
MELANIE UY ESPLANA MELISSA UY TAN-LEH
(Affiant) (Affiant)
Valid ID#_________________ Valid ID#_________________
With photo With photo

HANNALYN UY MENDOZA HENRICH D. UY

(Affiant) (Affiant)
Valid ID#________________ Valid ID#_________________
With photo With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: HENRY Y. UY and MERLYN D. UY, spouses, both of legal age,

both Filipinos, and both residents of Galas, Dipolog City, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

187. We are the owners of Open Fruits Stand subject for lease over a portion of
covered by Transfer Certificate of Title No.128-2017000529 situated at Galas,
Dipolog City registered under the name MH Top Corporation, which we owned;
188. A portion of an area of the property has encroached a portion which is
intended for road right of way;
189. In view thereof, we undertake to correct the area which encroached the
required setback for road right of way. We further undertake to limit all tenants on
their display of goods or products within the stall area posts and lastly the garbage
and all forms of wastes by end users or tenants shall be properly segregated or
maintained with trash bins in the area;
190. That should we fail to comply with this undertaking, the building permit
and other permits relative thereto shall automatically and immediately be revoked
or cancelled without any need for notice and hearing in relation to Section 306 of
PD 1096 providing for the grounds for the non-issuance, suspension/revocation of
building permits.
191. we hereby absolve from any liability the officers and employees of Office
of Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
 192. We are executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2023, at Dipolog City, Philippines.

HENRY Y. UY MERLYN D. UY
(Affiant) (Affiant)
Valid ID#_________________ Valid ID#_________________
With photo With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CESAR L. DALIGDIG, of legal age, Filipino, married, a resident of

Minaog, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: IZUSU SERIES: DMAX 4x2

CR NO.:309588753 ENGINE NO.:4JH1435357
CHASSIS NO.PABTFR77H60001610 MV FILE:1036-00000097020

That,the said vehicle was involved in a vehicular incident that transpired on

24 May 2023 at around or about 2:00 in the afternoon along National Highway,
Minaog, Dipolog City with another vehicle Yamaha STX bearing plate number
JZ-1510 driven by a certain Dino Mente Montimar;

That as result my above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
the name of Dra Julie H. Linog in my favor with the undertaking that I shall make
the same available to the Honorable Prosecutor or any authority in connection with
any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

CESAR L. DALIGDIG
(Affiant)
Driver’s License#K02-89-037990 valid until 2023/12/12s
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: JILL ROSE B. OLMEDO, single, of legal age, Filipino, and resident of

Purok Bonifacio, Punta, Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

193. I am an applicant for building permit over a portion of two

hundred(200) square meters of parcel of land denominated as Lot 2320-A-
8-F under PSD-09-083289 being a portion of Lot 2320-A-8, Psd-09-
079316 still covered by Transfer Certificate of Title No.128-2020000838
situated at Punta, Dipolog City with an area of 3,843 square meters;
194. I have utilized almost the entire area of land for my proposed residential
building and part of the requirements is a two(2) meter setback for the
 windows/openings from the wall of my proposed building to the boundary line of
adjacent lot which I was not able to comply;
195. In view thereof and to eliminate or cancel the requirement, I undertake to
build a concrete fence over my said property after completion of my proposed
residential building for processing and issuance of permit for the said building,
the said fence shall/must be 0.400m above the top most portion of the highest
opening and the wall must be 0.600m in horizontal distance from the last
fenestration or opening on both ends. I further undertake to comply with the
necessary setback required as I provided only 1.200 meters or protect the adjacent
area despite non-compliance of the required setback;
196. That should I fail to comply with this undertaking, the building permit and
other permits relative thereto particularly the temporary Electrical Connection
issued for the said building shall automatically and immediately be revoked or
cancelled without any need for notice and hearing in relation to Section 306 of PD
1096 providing for the grounds for the non-issuance, suspension/revocation of
building permits.
197. I hereby absolve from any liability the officers and employees of Office of
Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
198. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

JILL ROSE B. OLMEDO

(Affiant)
Valid ID#___________________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: JILL ROSE B. OLMEDO, single, of legal age, Filipino, and resident of

Purok Bonifacio, Punta, Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

199. I am an applicant for building permit over a portion of two

hundred(200) square meters of parcel of land denominated as Lot 2320-A-
8-F under PSD-09-083289 being a portion of Lot 2320-A-8, Psd-09-
079316 still covered by Transfer Certificate of Title No.128-2020000838
situated at Punta, Dipolog City with an area of 3,843 square meters;
200. I have utilized almost the entire area of land for my proposed residential
building and part of the requirements is a two(2) meter setback for the
 windows/openings from the wall of my proposed building to the boundary line of
adjacent lot which I was not able to comply;
201. In view thereof and to eliminate or cancel the requirement, I undertake to
build a concrete fence over my said property after completion of my proposed
residential building for processing and issuance of permit for the said building,
the said fence shall/must be 0.400m above the top most portion of the highest
opening and the wall must be 0.600m in horizontal distance from the last
fenestration or opening on both ends. I further undertake to comply with the
necessary setback required as I provided only 1.200 meters or protect the adjacent
area despite non-compliance of the required setback;
202. That should I fail to comply with this undertaking, the building permit and
other permits relative thereto particularly the temporary Electrical Connection
issued for the said building shall automatically and immediately be revoked or
cancelled without any need for notice and hearing in relation to Section 306 of PD
1096 providing for the grounds for the non-issuance, suspension/revocation of
building permits.
203. I hereby absolve from any liability the officers and employees of Office of
Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
204. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

JILL ROSE B. OLMEDO

(Affiant)
Valid ID#___________________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, RICHEE PAULO BALASE, of legal age, Filipino, married, a resident of

[Link], Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

76. I am currently employed by Department of Education-Dipolog City Division

Office;
77. I intend to resign as an employee of the Department of Education;
78. I have existing loans with BDO Network Bank-Dipolog City Branch and City
Savings Bank-Dipolog City Branch using my salaries and benefits as security;
79. My outstanding loan balance with BDO Network Bank is P590,292.18 and
with City Savings Bank is P146,556.28;
80. I hereby undertake that I will continue to pay my loan through over-the -
counter payment scheme despite my resignation from my employment;
81. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

RICHEE PAULO BALASE

(Affiant)
UMID ID#CRN-021-1939-6818-4
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at

Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I: NIZEL VINZ B. BARBASO, of legal age, Filipino, single, and resident of
Turno, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

205. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 3819-A-2, Psd-09-015854 situated at

Dapdap, Polanco, Zamboanga del Norte with an area of 4,957 square
meters covered by Transfer Certificate of Title No. T-44400 issued by
Register of Deeds for Zamboanga del Norte ”

206. The above stated parcel of land is agricultural land;

207. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
208. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
209. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
210. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

NIZEL VINZ BALINGIT-BARBASO

(Affiant)
UMID ID#CRN-0113-0154595-9
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I: KHIM VINCENT B. BARBASO, of legal age, Filipino, single, and resident of

Galas, Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

211. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 6175-C, Csd-09-000474-D situated at

Sangkol, Dipolog City, Zamboanga del Norte with an area of 19,545
square meters covered by Katibayan ng Orihinal na Titulo Blg.P1,211
issued by Register of Deeds for Dipolog City ”
212. The above stated parcel of land is agricultural land;
213. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
214. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
215. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
216. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

KHIM VINCENT B. BARBASO

(Affiant)
UMID ID#CRN-0111-3463234-3
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 That we, TRIFONY D. LUCHANA, married to M.a Shieryl Luchana; and
RAMON ERLO D. LUCHANA, married to Anabel Luchana; all of legal age, all Filipinos, all
residents of Dipolog City, represented by RENEBOY D. CALAPIZ, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:
217. We are the owners of parcels of land more particularly described as
follows:
“A parcel of land known as Lot 6189-E, Csd-09-001544 covered by Transfer
Certificate of Title No.T-61904 located at San Pedro, Polanco, Zamboanga del
Norte”
218. The above stated parcel of land is agricultural land;
219. The area purchased/inherited classified as agricultural land, we warrant not to
change the actual use of the property from agricultural land use to some other uses or
purposes;
220. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply documentary requirements
for Land Use Conversion Order, the application of which , to be filed before the DAR,
Regional Office, Zamboanga City/DAR, Central Office, Quezon City
221. We fully understand that any violation of the use of the land or any falsification
or misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
222. We are executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcels of land and for titling and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day of
___________2023, at Dipolog City, Philippines.

TRIFONY D. LUCHANA and RAMON ERLO D. LUCHANA

Represented by:

RENEBOY D. CALAPIZ
(Affiant)
Valid ID#__________________
With photo

SUBSCRIBED AND SWORN to before me with identification document as shown above by

affiant this ___ day of _________ 2023, at Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HYSTER SANORIA HALASAN, of legal age, Filipino, married, a resident of

Imelda, Labason, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

82. I completed the academic requirements for a degree of Doctor of Educational

Management, a post graduate course, with the Saint Vincent’s College, Inc-
Dipolog City;

83. I processed for the Honorable Dismissal and other papers in furtherance of my
academic profession with Mandaue City College in Mandaue City;

84. I received my relative documents however I did not pursue the submission of
my documents with the said Mandaue City College due to undersigned’s
hesitancy in the value of education that the said college has offered;

85. I hereby undertake that I did not continue my studies and did not submit the
pertinent papers like the Honorable Dismissal and others to the said Mandaue
City College;

86. I execute this affidavit for the purpose of securing similar certification,
authentication,verification(CAV) from CHED and others for my work
requirements;

87. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

HYSTER SANORIA HALASAN

(Affiant)
Driver’s License#J05-97-005551 valid until 2023/10/14
With photo

SUBSCRIBED AND SWORN to before me using her document of identity as

shown above as proof of identification this __th day of _________ 2023, at Dipolog City.

[Link].
PAGE NO.
BOOK NO.
SERIES OF 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, GINZAR C. ZAMORA, of legal age, Filipino, single, a resident of Obay,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

88. I am the son and attorney-in-fact of GINA C. MAYOL being authorized to

pay her debts to banks due to her employment with Department of Education;
89. Her employment was used as security in her loan;
90. I hereby undertake that her monthly amortizations with One Network Bank-
Dipolog City Branch with regard to her loans shall be paid by undersigned
under the over-the-counter payment scheme using her money;
91. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

GINZAR C. ZAMORA
(Affiant)
Driver’s License#J01-20-009697 valid until 10/15/2024
With photo

SUBSCRIBED AND SWORN to before me using her document of identity as

shown above as proof of identification this __th day of _________ 2023, at Dipolog City.

[Link].
PAGE NO.
BOOK NO.
SERIES OF 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we, TEODORVINE S. EVARDO, of legal age, Filipino, widow, resident of

Central Barangay, Dipolog City;ELPIDIO SAGARIO, of legal age, Filipino, married to Henrita
Sagario, resident of Turno, Dipolog City;HEIR OF AMANDO SAGARIO, named: BRYAN
SAGARIO, of legal age, Filipino, single, resident of Obay, Polanco, Zamboanga del
Norte;PERLITO SAGARIO, of legal age, Filipino, widower, resident of Dipolog
City;RIZALITO SAGARIO, of legal age, Filipino, single, resident of Dipolog City; HEIRS OF
ERLINDA S. MONTILLA, namely:GEMMA S. MONTILLA, single; JOSE NESTOR S.
MONTILLA, single; APOLLO S. MONTILLA,single;and, URBANO S. MONTILLA, single; all
of legal age, all Filipinos, all residents of Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:
223. We are the owners of parcels of land more particularly described as
follows:
A.“A parcel of land known Lot 171-A, Psd-09-000285, situated at Patunan,
Manukan, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.T-86507, containing an area of 12,058 square meters”
B.A parcel of land known Lot 171-G, Psd-09-000285, situated at Patunan,
Manukan, Zamboanga del Norte, and covered by Transfer Certificate of Title
No.T-86508, containing an area of 3,827 square meters”

224. The above stated parcels of land are agricultural lands;

225. The area purchased/inherited classified as agricultural lands, we warrant not to
change the actual use of the property from agricultural land use to some other uses or
purposes;
226. In the future, the transferee will decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply documentary requirements
for Land Use Conversion Order, the application of which , to be filed before the DAR,
Regional Office, Zamboanga City/DAR, Central Office, Quezon City
 227. We fully understand that any violation of the use of the land or any falsification
or misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
228. We are executing this affidavit to attest to the truth of the foregoing statements
and for subdivision of said parcels of land and for titling and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day of
___________2023, at Dipolog City, Philippines.

ELPIDIO SAGARIO
(Affiant)
TIN#114-6960031

BRYAN SAGARIO /PERLITO SAGARIO/RIZALITO SAGARIO/ GEMMA S.

MONTILLA/JOSE NESTOR S. MONTILLA/ APOLLO [Link]/URBANO
[Link]
[Link]:

TEODORVINE S. EVARDO
(Affiant)
TIN#180-510-105
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: DENNIS D. MEJOS, single, of legal age, Filipino, and resident of

Bonifacio cor. Martinez Sts, Barra, Dipolog City, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

229. I am an applicant for building permit over a portion of parcel of

land covered by Transfer Certificate of Title No.T-36175 which I owned
pursuant to Deed of Absolute Sale notarized by Ivo Mandantes per Doc.
No.4129, Page No.58, Book [Link], Series of 2022 at LGU-Dipolog City;
230. I have utilized almost the entire area of land for my proposed building and
part of the requirements is a two(2) meter setback which I was not able to comply;
231. In view thereof, I undertake to build a concrete fence over my said
property after completion so that the requirement of the Office of the Building
Official, LGU-Dipolog City will issue the permit and the adjacent landowner will
be protected;
232. I hereby absolve from any liability the officers and employees of Office of
Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
233. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

DENNIS D. MEJOS
(Affiant)
Driver’s License#J01-22-301391______
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we, RUDITA M. BALBUENA, widow; LUZMINDA M. ANGUB,

married to Eniego Angub; RODERICK M. MAGHANOY,single; ANACLETO M.
MAGHANOY, JR, married to Emerita Maghanoy; AIREEN M. BAJE, married to
Richard Baje; OPHELIA T. MONTAÑO, widow;WINDELL T. MONTAÑO, married to
Marietta P. Montaño; CHOLIE M. ROBLE, married to Rico Roble; NIDA M.
QUIMIGUING, widow; EMMA M. TORMIS, widow; ELENITA M. AGPAWA,
married to Gerardo Agpawa; and REYNALDO A. MONTAÑO, married to Lydia R.
Montaño,; all of legal age, all Filipinos, all residents of Baybay, Liloy, Zamboanga del
Norte, after having been duly sworn to an oath in accordance with law, do hereby depose
and say the following, THAT:
234. We are the transferees of parcels of land more particularly
described as follows:
A.“A parcel of land known as Lot 794, Pls-65 situated at San Isidro,
Liloy, Zamboanga del Norte with an area of 185,582 square meters
covered by Original Certificate of Title No. P-2334 issued by the Register
of Deeds for Zamboanga del Norte ”
B.“A parcel of land known as Lot 189-B-2-C, Psd-09-012928 situated at
[Link]ño, Liloy, Zamboanga del Norte with an area of 708 square meters
covered by Transfer Certificate of Title No. T-58614 issued by the Register
of Deeds for Zamboanga del Norte ”
235. The above stated parcels of land are agricultural lands;
236. The area purchased/inherited classified as agricultural lands, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
237. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
238. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
239. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2023, at Dipolog City, Philippines.

RUDITA M. BALBUENA LUZMINDA M. ANGUB

(Heir) (Heir)
OSCA ID#LIL-03192-Liloy,ZN OSCA ID#LIL-00761-Liloy, ZN

CHOLIE M. ROBLE EMMA M. TORMIS

(Heir) (Heir)
OSCA ID#071923-Liloy,ZN OSCA ID#LIL-010203-Liloy,ZN

REYNALDO A. MONTAÑO ELENITA M. AGPAWA

(Heir) (Heir)
TIN#470-784-644 SSS ID#10-0863585-8

NIDA M. QUIMIGUING RODERICK M. MAGHANOY

Represented by: (Heir)
VIN#7206-0013C-J0571RMM200034
EMMA M. TORMIS

AIREEN M. BAJE ANACLETO M. MAGHANOY,JR

(Heir) (Heir)
Employee ID#01-01-1038 TIN#448-636-379
Mutia,ZN

OPHELIA T. MONTAÑO WINDELL T. MONTAÑO

(Heir) (Heir)
OSCA ID#LIL-03144-Liloy,ZN DL#J01-10-002140

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ROSEMARIE FERNANDEZ DAEL, of legal age, Filipino,

married, a resident of Olingan, Dipolog City, Zamboanga del Norte,
after having been duly sworn to an oath in accordance with law, do hereby depose and
state, that:

92. I am currently employed by Department of Education-Zamboanga del Norte

Division Office;
93. I intend to transfer in Department of Education-Dipolog City Division;
94. I have an existing loan with BDO Network Bank-Dipolog City;
95. I utilize my employment as security on my said application for loan;
96. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new work assignment even after the transfer at DepEd-
Dipolog City Division;
97. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
remaining claims at Department of Education and/or other sources of
obligation;
98. I am executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

ROSEMARIE FERNANDEZ DAEL

(Affiant)
PRC ID#1052497 until 4/09/2024
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at

Dipolog City.
DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CARLOS SAMBORIO HINOTAN, of legal age, Filipino, single,

a resident of Highway Barangay Dos, Katipunan, Zamboanga del
Norte, after having been duly sworn to an oath in accordance with law, do hereby
depose and state, that:

99. I am currently employed by Department of Education-Zamboanga del Norte

Division Office;
100. I intend to retire from service effective immediately upon approval of
retirement;
101. I have an existing loan with Katipunan Banking Corporation;
102. I utilize my employment as security on my said application for loan;
103. I hereby undertake that I will pay my loan with Katipunan Banking
Corporation within six(6)months from this undertaking;
104. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
remaining claims at Department of Education and/or other sources of
obligation;
105. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

CARLOS SAMBORIO HINOTAN

(Affiant)
UMID ID#CRN-006-0111-0762-4
With photo
 SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at
Dipolog City.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: EDANNA AGRIVENTURES INC, a corporation created by laws of the

Philippines with address of Purok 8, Padre Faura St., Imelda, Labason, Zamboanga del
Norte, represented by its President Cybill Ingrid C. Montemayor, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

240. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 2863-B, Psd-09-011312 situated at Gabu,

Labason, Zamboanga del Norte with an area of 55,795 square meters
covered by Transfer Certificate of Title No. T-54178 issued by Register of
Deeds for Zamboanga del Norte ”

241. The above stated parcel of land is agricultural land;

242. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
243. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
244. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
 245. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

EDANNA AGRIVENTURES, INC

Represented by:

CYBILL INGRID C. MONTEMAYOR

(Affiant)
PRC ID#0139564
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we, NILO R. CAIDET, married to Jolyn Caidet; MARLITO D.

CAIDET, single;LIMAR D. CAIDET, married to Jane Caidet; ANNLIMARIE D.
CAIDET, single; ROY D. CAIDET, single; LOVELY ANN D. CAIDET, single; JAY D.
CAIDET, single; MAE ANN D. CAIDET, single; all of legal age, all Filipinos, and all
residents of San Antonio, Polanco, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say the following, THAT:
246. We are the transferees of parcel of land more particularly described
as follows:
“A parcel of land known as Lot 323-C, Psd-09-009391 situated at San Antonio, Polanco,
Zamboanga del Norte with an area of 10,001 square meters covered by Transfer
Certificate of Title No. T-406401 issued by Register of Deeds for Zamboanga del Norte
247. The above stated parcel of land is agricultural land;
248. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
249. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
250. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
 251. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2023, at Dipolog City, Philippines.

NILO R. CAIDET
(Affiant)
VIN#7210007A1159NRC100006

JOSE GERRY R. CAIDET MARLITO D. CAIDET

(Affiant) (Affiant)
VIN#72100077AE1572JGC100003 PNP #16J070284

ANGELITA R. CAIDET
(Affiant)
SSS#10-0555878-9

LIMAR CAIDET ANNLIMARIE D. CAIDET ROY D. CAIDET

(Affiant) (Affiant) (Affiant)
DL#J01-12-003163 VIN#72100077AK0292 VIN#72100078BG1897
ADC1200008 RDC100005

LOVELY ANN D. CAIDET JAY D. CAIDET

(Affiant) (Affiant)
School ID#15DF201525 School ID#639185
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: RICHARD DARCERA DURANTE single, of legal age, Filipino, and

resident of Baybay Liloy, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

252. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 9, Pcs-12700 situated at Gayam(now

Villa M. Tejero), Liloy, Zamboanga del Norte with an area of 30,806
square meters covered by Transfer Certificate of Title No. T-22417 issued
by Register of Deeds for Zamboanga del Norte ”
 253. The above stated parcel of land is agricultural land;
254. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
255. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
256. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
257. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

RICHARD DARCERA DURANTE

(Affiant)
Philippine Passport#P2288714C valid until 7 Nov 2032

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I: SHARIKA D. JUMAWAN, married, of legal age, Filipino, and resident
of Blk13 Lot 18 VCH, Obay, Polanco, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

258. I am the head of office of Barra Elementary School, with address of

Barra, Dipolog City;
259. Barra Elementary School is an applicant for building permit before
the Office of Building Official, LGU-Dipolog City for Construction of
Two(2) Storey, Six(6) Classroom School;
260. Part of the requirement of Building Permit is an approved
Construction Safety and Health Program(CSHP) by Department of Labor
and Employment(DOLE);
261. Barra Elementary School has already submitted the documents to DOLE
for approval.
262. In view thereof, I undertake to submit immediately to the Office of the
Building Official, LGU-Dipolog City once the DOLE approved CSHP document
is released;
263. I hereby absolve from any liability the officers and employees of Office of
Building Official-LGU Dipolog City relative to above stated transaction and
release of pertinent permit/document;
264. I am executing this affidavit to attest to the truth of the foregoing
statements and for approval of building permit and whatever legal purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

SHARIKA D. JUMAWAN
(Affiant)
Driver’s License#J01-07-001696
With photo
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Doc. No
Page No
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: ANGELITA R. CAIDET, single, of legal age, Filipino, and resident of

San Antonio, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:
 265. I am the transferee of parcel of land more particularly described as
follows:

“A parcel of land known as Lot 371-A, Psd-09-045054 situated at

Lingasad, Polanco, Zamboanga del Norte with an area of 6,057 square
meters covered by Transfer Certificate of Title No. T-67884 issued by
Register of Deeds for Zamboanga del Norte ”

266. The above stated parcel of land is agricultural land;

267. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
268. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
269. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
270. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

ANGELITA R. CAIDET
(Affiant)
SSS#10-0555878-9

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LORENA B. DUNQUE, of legal age, Filipino, a resident of

Labrador, Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

106. I am the authorized representative of SECC Computer Sales;

107. SECC Computer Sales is a registered employer at the Social Security
System(SSS) with SS Number 10-0730918-5;
108. As employer, SECC Computer Sales is authorized to withhold and remit
contributions with SSS;
109. For the months of January-March 2011, SECC Computer Sales had
remitted with the SSS the contributions of former’s employees including the
employer’s share;
110. However, it appeared from the records of SSS that there was no remittance
made;
111. Attached are proofs of remittance;
 112. I hereby undertake to comply and remit the remittances whether employee
or employer’s share in the event it is found out that there was no remittance
made in view of the submitted proofs;
113. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

LORENA B. DUNQUE
(Affiant)
Valid ID#___________________

SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at

Dipolog City.

DO. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, GERLIN GERODIAS BANLAYGAS, of legal age, Filipino,

single, a resident of New Tambo, Katipunan, Zamboanga del Norte,
after having been duly sworn to an oath in accordance with law, do hereby depose and
state, that:

114. I am currently employed by Department of Education-Zamboanga del

Norte Division Office;
115. I intend to transfer my current assignment into Department of Education -
Dipolog City Division Office;
116. I am an applicant for loan or has an existing loan with Chinabank Savings-
Dipolog Branch Lite while I am assigned at the DepEd-Zamboanga del Norte
Division Office
 117. I utilize my employment as security on my said application for loan;
118. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new work assignment even after the transfer at DepEd-
Dipolog City Division;
119. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
120. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2023, at Dipolog City, Philippines.

GERLIN GERODIAS BANLAYGAS

(Affiant)
PRC ID#1768760-Professional Teacher
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2023, at

Dipolog City.

DO. NO.
PAGE NO.
BOOK NO.
SERIES OF 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I, ROCKIE LAUNGAYAN, Filipino, married to Maribel Laungayan, of

legal age, resident of Poblacion Bajo, Sergio Osmena, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

271. I am transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 2894, situated at Poblacion Bajo, Sergio

Osmena, Zamboanga del Norte, and covered by Original Certificate of
Title No.P-28409, containing an area of 24,917 square meters issued by
Register of Deeds for Zamboanga del Norte”.
272. The above stated parcel of land is agricultural land;
273. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
 274. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
275. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
276. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

ROCKIE LAUNGAYAN
Affiant
Valid ID#____________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I,ROLANDO E. JERUSALEM, Filipino, married to MERLE SARIGUE

JERUSALEM, of legal age, resident of Sto. Nino, Polanco, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

277. I am the transferee of portion of parcel of land more particularly

described as follows:
 “A parcel of land known as Lot 6661-B, Csd-09-009005, situated at
[Link], Polanco, Zamboanga del Norte, and covered by Katibayan ng
Orihinal na Titulo Blg. 2022000177, containing an area of 7,204 square
meters issued by Register of Deeds for Zamboanga del Norte”.
278. The above stated parcel of land is agricultural land;
279. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
280. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
281. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
282. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

ROLANDO E. JERUSALEM
Affiant
TIN#272-320-434
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ERMELYN R. YAP, Filipino, widow, of legal age, resident of Airport Rd.,

Sicayab, Dipolog City, after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

283. I am the co-owner of parcel of land more particularly described as

follows:
 “A parcel of land, situated at Minaog, Dipolog City, Zamboanga del
Norte, and covered by Transfer Certificate of Title No.T-28545 issued by
Register of Deeds for Dipolog City, containing total area of (20,628)
square meters”.
284. I am an applicant for permit before the Office of the Building Official-
Dipolog City for a building made of light material beside the said parcel of land;
285. The said structure is located on an area which is considered part of the
road right of way;
286. I hereby undertake that I would remove the structure after one(1) year only
without cost provided permit is granted and operation of the business be given;
287. I hereby release officers of the Office of the Building Official and Local
Government Unit of Dipolog City from any liabilities/responsibilities on the frant
of this permit;
288. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________202_, at Dipolog City, Philippines.

ERMELYN R. YAP
Affiant
PRC ID#0334638
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 202_, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CARLO JAY V. VILLARIN, of legal age, Filipino, single/married, a

resident of Sicayab, Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:
 That I am the owner of a motor vehicle, which is more particularly
described as follows;

MAKE: Kawasaki SERIES: RNS160A

CR NO.:42799094-2 ENGINE NO:JEXCMB49366
CHASSIS NO.MD2A92CX3MCB83605 MV FILE:0908-00003381256

That,the said vehicle was involved in a vehicular incident that transpired on

September 21, 2022 at around or about 6:00 in the evening along National
Highway, Sta. Filomena, Dipolog City with another vehicle;

That as result the above mentioned vehicle was impounded by the

Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my name to undersigned or my representative with the undertaking that I shall
make the same available to the Honorable Prosecutor or any authority in
connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of _______________ 2023, at Dipolog City, Philippines.

CARLO JAY V. VILLARIN

(Affiant)
VIN#72010162BE1697CVV100000
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2023,

at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2023

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I,KATHERINE J. PIALA, Filipino, married to JESSE C. PIALA, of legal

age, resident of San Pedro, Polanco, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say the following, THAT:

289. I am the transferee of portion of parcel of land more particularly

described as follows:
 “A parcel of land known as Lot 7669-A, Csd-09-009325, situated at
Dansullan, Polanco, Zamboanga del Norte, and covered by Katibayan ng
Orihinal na Titulo Blg. P-49845 issued by Register of Deeds for
Zamboanga del Norte”.
290. The above stated parcel of land is agricultural land;
291. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
292. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
293. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
294. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2023, at Dipolog City, Philippines.

KATHERINE J. PIALA Marital Consent:

Affiant
PRC ID#0673020 JESSE C. PIALA
With photo DL#J01-10-001593

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2023, at Dipolog
City.

DOC. NO. DARIO M. MANDANTES

PAGE NO. Notary Public for Dipolog City, Dapitan
City
BOOK NO. and Zamboanga del Norte
SERIES OF 2023 Attorney’s Roll No.51545
Commission No.036-2022
PTR No.2625307-1/3/2023
Valid until 12/31/2023
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I,KRISTENE MAE C. CARPO, Filipino, married to Michel Carpo, of legal age,

resident of Dawo, Dapitan City, after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

295. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 1634-B, situated at Santa Catalina, La

Libertad, Zamboanga del Norte, and covered by Transfer Certificate of
Title No.T-83899 issued by Register of Deeds for Zamboanga del Norte,
containing total area of (20,628) square meters”.
296. The above stated parcel of land is agricultural land;
297. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
298. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
299. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
300. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

KRISTENE MAE C. CARPO

Affiant
TIN#296-832-567
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2022, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That I,EDDOR S. EVARDO, Filipino, single, of legal age, resident of New

Lower Bicutan Taguig City, after having been duly sworn to an oath in accordance with
law, do hereby depose and say the following, THAT:

301. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 593-E, situated at Patunan, Manukan,

Zamboanga del Norte, and covered by Transfer Certificate of Title No.T-
39254 issued by Register of Deeds for Zamboanga del Norte, containing
total area of (20,680) square meters”.
302. The above stated parcel of land is agricultural land;
303. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
304. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
305. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
306. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

EDDOR S. EVARDO
Represented by:

TEODORVINE S. EVARDO
Affiant
ID#__________________
With photo
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2022, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That we, Spouses RODRIGO C. BAHI-AN,JR and FLOR G. BAHIAN, both

Filipinos, both of legal age, both residents of Tolon, Rizal, Zamboanga del Norte,after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

307. We are the transferees of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 197, PSD-100, situated at

Maniway(Poblacion),Rizal, Zamboanga del Norte, and covered by
Original Certificate of Title No.P-31009 issued by Register of Deeds for
Zamboanga del Norte, containing total area of (16,430) square meters”.
308. The above stated parcel of land is agricultural land;
309. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
310. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
311. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
312. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

RODRIGO C. BAHI-AN,JR/FLOR G. BAHI-AN

Affiants
PRC ID#0917424 PRC ID#0917425
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2022, at Dipolog
City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That,I, LHOHAMA R. DUMADAG, Filipino, of legal age, married to Lee

Kookhyung, resident of Villahermosa, Polanco, Zamboanga del Norte,after having been
duly sworn to an oath in accordance with law, do hereby depose and say the following,
THAT:

313. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot No.3757, situated at Villahermosa,

Polanco(then Dipolog), Zamboanga del Norte, and covered by Transfer
Certificate of Title No.127-2019001188 issued by Register of Deeds for
Zamboanga del Norte containing an area of 13,402 square meters.”
314. The above stated parcel of land is agricultural land;
315. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
316. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
317. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
318. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

LHOHAMA R. DUMADAG
(Affiant)
Represented by:
ELENA R. DUMADAG
Attorney-in-fact
(Per SPA notarized by Ivo M. Mandantes per Doc. No.2984, Page No.39, Book [Link],
Series of 2022

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2022, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That,we: JAY Q. ADANES and CARYLL E. PUCONG, both Filipinos, both of

legal age, both residents of San Antonio, Polanco, Zamboanga del Norte,after having
been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

319. We are the transferees of portion of parcel of land more particularly

described as follows:

“A parcel of land, situated at San Antonio, Polanco, Zamboanga del

Norte, and covered by Transfer Certificate of Title No.127-2018000769
issued by Register of Deeds for Zamboanga del Norte.”
320. The above stated parcel of land is agricultural land;
321. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
322. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
323. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
324. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

JAY Q. ADANES & CARYLL E. PUCONG

Rep. by

EDITA Q. ADANES
 (Affiant)
Per SPA notarized by Arnold D. Naval per Doc. No.327, Page No.67, Book No.I, Series
of 2021

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

AFFIDAVIT OF UNDERTAKING

I, JAY OBNIMAGA NARVACAN, married, of legal age, resident of Bolicon, Turno,

Dipolog City, Philippines, a bonafide pensioner of the Philippine National Police,
after being sworn to in accordance with the law, do hereby depose and state that:

a) I am a pensioner of the Philippine National Police/Integrated National Police since

November 1, 2019,with the pension amount of Twenty Eight Thousand Two Hundred
Ten Pesos and Eighty Seven Centavos(P28,210.87)Philippine currence;

b) Consistent with the requirements of the Philippine National Police Retirement and
Benefits Administration Service (PRBS), I hereby bind and oblige myself to update
my retirement records during my birth month;

c) In case of physical incapacity, illness or medical condition which will prevent my

person from performing the aforestated obligation, I hereby appoint and constitute
my legal wife __MARILOU RUDAS or my daughter/son (in case of unmarried retiree,
state the name of nearest kin) _____________ as my lawful attorney-in-fact to
transact business relating to my status as a PNP/INP pensioner with PRBS;

d) Consistent with the intent embodied in this instrument, my designated attorney-in-

fact shall inform the PRBS of any circumstances that will happen to my person.
Further they will be the custodian of my pension ATM Card and passbook account
with the obligation of managing the same with due regard to its nature as
government funds and subsequent civil and criminal liabilities under the pertinent
provisions of the New Civil Code of the Philippines and Republic Act 8484;

e) Further, I hereby acknowledge the authority of the PNP to place my pension

account on “tag and hold” status in the event of my failure to update my retirement
records during the period provided under the rules or non-reporting by my
designated attorney-in-fact of any untoward circumstance that will happen to my
person.

Done this ____ day of _______, ______, in Dipolog City, Philippines.

JAY OBNIMAGA NARVACAN

(Affiant)

Our conformity:
1.__MARILOU RUDAS
(Name)
Relationship _Wife
Contact Number _09103379219
Complete Address _Bolicon, Turno, Dipolog City
2. _________________________
(Name)
Relationship _________________
Contact Number ______________
Complete Address ____________
(N.B. This Affidavit shall not be accepted by PRBS if not notarized)

Sworn and subscribed to before me this ______ day of ________, 2022, Dipolog City, Philippines.
NOTARY PUBLIC
Page No:______
Document No:___
Book No:_____
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JAY OBNIMAGA NARVACAN, of legal age, Filipino, married, a

resident of Bolicon, Brgy. Turno, Dipolog City, after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

a. I am a pensioner of the Philippine National Police

121. I am a pensioner of Social Security System(SSS);
122. My monthly pension with SSS is Three Thousand Five
Hundred(P3,500.00)Philippine Pesos;
123. My child Mary Jane Y. Escal intends to apply for loan with Paglaum
Multipurpose Cooperative;
124. I hereby undertake that I will allow, consent and authorize my said child
Mary Jane Y. Escal to utilize my monthly pension as collateral for theloan she
will contract or contracted with Paglaum Multipurpose Cooperative;
125. In the event I will not comply with this undertaking, I hereby authorize the
said ccoopetative to claim whatever balance of the obligation incurred from
my account;
126. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

ESTERLITA Y. ESCAL
(Affiant)
SSS ID#10-0565445-0
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

BRENDA LOU LOVELY N. ABANILLA, Filipino, of legal age, married to

Rudolfo Mark B. Abanilla, resident of Sta. Isabel, Dipolog City, Zamboanga del Norte
rep. by TEOFREDA H. NOEL,after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

325. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 160-B-2, Psd-09-055649, situated at

Dinonum, Pinan, Zamboanga del Norte, and covered by Transfer
Certificate of Title No.T-82026 issued by Register of Deeds for
Zamboanga del Norte, containing total area of (3,940) square meters”.
326. The above stated parcel of land is agricultural land;
327. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
328. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
329. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
 330. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

BRENDA LOU LOVELY N. ABANILLA

Represented by:

TEOFREDA H. NOEL
(Affiant)
OSCA ID#18684, Dipolog City

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: LIGAYA GENERAL CORDOVA,of legal age, Filipino, married, resident of

Bolicon, Turno, Dipolog City, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am an applicant for passport at the Department of Foreign Affairs;

That there is a discrepancy in my Certificate of Marriage and Certificate of Live

Birth with regard to my place of birth. In my Certificate of Marriage, my place of birth is
indicated as Colicog, Dohinob, ROxas, ZN while in my Certificate of Live Birth, my
place of birth is indicated as Dohinob, Pres. M.A. Roxas, Zambo. Norte;

That I acknowledge this error of my place of birth as a pure mistake considering

that Colicog was my particular place of birth and it was still part of Dohinob, President
Manuel [Link], Zamboanga del Norte at the time of my birth;

That I hereby undertake that I will file proper petition before the court or local
civil registrar for the correction of the said mistake and I will present an annotated
correction of my Certificate of Marriage or Birth before the DFA during future renewal
of my passport;

That I hereby agree and consent that my name be included in the DFA Watchlist;

That I hereby attest the truthfulness of foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of

October 2022, at Dipolog City, Philippines.

LIGAYA GENERAL CORDOVA

(Affiant)
UMID ID#CRN-0111-2730077-7
With photo

SUBSCRIBED AND SWORN to before me this ___ day of October 2022, at

Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:DANIEL R. MAQUILAN aka Justine R. Maquilan, minor, single, Filipino,

resident of Purok Tunggo, Minaog, Dipolog City, Zamboanga del Norte assisted by
mother CONCEPCION R. DUHAYLUNGSOD, after having been duly sworn to an oath
in accordance with law, do hereby depose and state, that:

331. I am the accused in the case titled People of the Philippines vs. JUSTINE
R. MAQUILAN whose actual name is DANIEL R. MAQUILAN with Criminal
Case No.25126 pending before Regional Trial Court Branch 7, Dipolog City;
332. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
333. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
 334. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

DANIEL R. MAQUILAN
(Affiant)
CTC [Link] 2021 08067834 issued at Dipolog City-9/27/2022

Assisted by:

CONCEPCION R. DUHAYLUNGSOD
Mother of Affiant

SUBSCRIBED AND SWORN to before me this __th day of September 2022, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:NOEL M. GUERRERO, of legal age, married, Filipino, resident of Letapan,

Polanco, Zamboanga del Norte after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:
 335. I am the accused in the case titled People of the Philippines vs. NOEL M.
GUERRERO with Criminal Case No.__________ pending before Regional Trial
Court Branch 7, Dipolog City;
336. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
337. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
338. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

NOEL M. GUERRERO
(Affiant)
DILG ID#097210011-01
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 2022, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:DAVY JANE DAGOHOY DAGAYLOAN, of legal age, single, Filipino,

resident of MIas, Katipunan, Zamboanga del Norte after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

339. I am the accused in the case titled People of the Philippines [Link]
JANE DAGUHIY DAGAYLOAN with Criminal Case Nos.25648 and 25649
pending before Regional Trial Court Branch 7, Dipolog City;
340. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
341. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
 342. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

DAVY JANE DAGOHOY DAGAYLOAN

(Affiant)
Philhealth ID#14-252676054-8
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 2022, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF RELEASE AND QUITCLAIM WITH INDEMNITY

UNDERTAKING

We: HEIRS OF TRUMAN C. SORRONDA, namely: CLYDE T. SORRONDA,

married; RYAN T. SORRONDA, single;and, JOJIT T. SORRONDA, married; all
residents of Turno, Dipolog City;[Link] C. SORRONDA, single, resident of Turno,
Dipolog City; [Link] OF CONCEPCION S. DALMAN, named VIVIAN D.
BHAGWANI, married, resident of Paranaque City; [Link] OF NIEVES S. BUENO,
namely: ALMA B. SINDO, single, resident of Lorenzo Garden Ville, Dipolog City;
CHARITO B. GUANTERO, married to Joseph Guantero, resident of Victoria Hills, Pob.
North, Polanco, Zamboanga del Norte; [Link] OF DRONICO C. SORRONDA,
namely: ADELFA S. TRANI, married to Albert Trani, resident of Igot, Dipolog City;
ALLAN L. SORRONDA, married to Sally Sorronda, resident of Igot, Turno, Dipolog
City; [Link] OF JOVENCIA S. SALDIA, namely: ARSENIO S. SALDIA, married to
Ma. Teresa P. Lluch, resident of Purok 10, Barangay Saray, Iligan City; 7. HEIR OF
ANTONIO SORRONDA, named HEIDI S. SORRONDA-ADASA, married, resident of
Sicayab, Dipolog City; all of legal age; all Filipinos,herein represented by their attorney-
in-fact, ADELFA S. TRANI in accordance with Special Power of Attorney dated April
20, 2022, under oath, do hereby declare and state that:
We are the heirs of the late NORMA C. SORRONDA who died intestate on
September 09, 2017 at ZN Cooperative Hospital, Turno, Dipolog City,
Zamboanga del Norte(the Deceased), and left no known debts;

For and in consideration of my/our receipt of the amount of Php474,194.99

plus the accruing interests, representing proceeds of PESO SAVINGS
ACCOUNT NO.003130138697 of the Deceased with BDO Unibank, Inc,-
Dipolog Quezon Branch(the “Account”). We hereby expressly and absolutely
remiss, release and forever discharge BDO Unibank, Inc, its owners, directors,
stockholders, officers, employees and assignes(collectively, “BDO”)from any
and all claims, suits, actions or causes of action which we, my/our
succesors/assignes now have or in the future claims to have against BDO in
connection with the Account.

I/we hereby further obligate myself/ourselves, jointly and severally to

indemnify BDO for any loss or damages which it may sustain in the event that
any third person/s shall succeed in establishing a right superior to that of
mince/ours concerning the Account.

FURHTER AFFIANT/S SAYETH NAUGHT.

CLYDE T. SORRONDA RYAN T. SORRONDA JOJIT T. SORRONDA

(Affiant) (Affiant) (Affiant)

ERMA C. SORRONDA ALMA SINDO CHARITO GUANTERO

(Affiant) (Affiant) (Affiant)

ADELFA TRANI ARSENIO S. SALDIA VIVIAN D. BHAGWANI

(Affiant) (Affiant) (Affiant)

ALLAN L. SORRONDA HEIDI S. SORRONDA-ADASA

(Affiant) (Affiant)

Represented by:

ADELFA S. TRANI JOJIT T. SORRONDA ERMA C. SORRONDA

Attorney-in-fact Attorney-in-fact of Attorney-in-fact of Vivian
Of all other affiants Heidi S. Adasa Bhagwani

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City affiants exhibiting to me their competent evidence of identity as follow
Name Competent Evidence of Identity Issued on Issued at Valid until
CLYDE SORRONDA VIN#7202-0179A-J2270CTS10000-1 N/A Commission on Election
RYAN T. SORRONDA VIN#7202-0179A-F1872RTS10000-5 N/A Commission on Election
JOJIT T. SORRONDA DL#J01-20-004070 N/A Land Transportation Office 8/29/2024
ERMA C. SORRONDA SC#9363 N/A Office of Senior Citizens Affaris,Dipolog City
ALMA SINDO SC#14924 N/A Office of Senior Citizens Affaris,Dipolog City
CHARITO GUANTERO UMID#CRN-2003021221 N/A Government Service Insurance System
ADELFA TRANI UMID#CRN-006-0072-8932-3 N/A Government Service Insurance System
ARSENIO S. SALDIA DL#J09-03-003306 N/A Land Transportation Office 12/12/2022

Doc. No.___________
Page No._________
Book No.__________
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I: MA ROSEDAN NECOSIA DAUG, of legal age, Filipino, married, resident of

Purok Parpagayo, Minaog, Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:
 That I am the beneficiary of DANIEL A. NECOSIA who had a bank account,
more specifically described as follows:
TIME DEPOSIT in the amount of ONE HUNDRED SIXTY THOUSAND FOUR
HUNDRED FIFTY-FOUR PESOS and SEVENTY-NINE CENTAVOS(P160,454.79)
per Special Certificate of Time Deposit No.719 C at ZAMBOANGA DLE NORTE
COOPERATIVE BANK-Dipolog City issued on June 7, 2022;

That Daniel A. Necosia died intestate; That I undertake and declare that I am the
beneficiary of Daniel A. Necosio and I am entitled to the said account;

That for and in consideration of my/our receipt of the amount plus the accruing
interests, representing proceeds of said account(the “Account”). I/we hereby expressly
and absolutely remiss, release and forever discharge ZAMBOANGA DEL NORTE
COOPERATIVE BANK, its owners, directors, stockholders, officers, employees and
assignes from any and all claims, suits, actions or causes of action which we, my/our
succesors/assignes now have or in the future claims to have against ZAMBOANGA DEL
NORTE COOPERATIVE BANK in connection with the Account;

That I/we hereby further obligate myself/ourselves, jointly and severally to

indemnify ZAMBOANGA DEL NORTE COOPERATIVE BANK for any loss or
damages which it may sustain in the event that any third person/s shall succeed in
establishing a right superior to that of mince/ours concerning the Account.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of

September 2022, at Dipolog City, Philippines.

MA. ROSEDAN NECOSIA DAUG

(Affiant)
Driver’s License#J01-99-030497
With photo

SUBSCRIBED AND SWORN to before me this ___ day of September 2022, at

Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

 I:LEO JAY MARK PEREZ y Gumate, of legal age, single/married, Filipino,
resident of Purok Dela Paz, Sicayab, Dipolog City, Zamboanga del Norte after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

343. I am the accused in the case titled People of the Philippines [Link] JAY
MARK PEREZ with Criminal Case No.25810 pending before Regional Trial
Court Branch 10, Dipolog City;
344. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
345. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
346. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

LEO JAY MARK G. PEREZ

(Affiant)
Valid ID#___________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 2022, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2022
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ESTERLITA Y. ESCAL, of legal age, Filipino, widow, a resident

of Sta. Isabel, Dipolog City, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

127. I am a pensioner of Social Security System(SSS);

128. My monthly pension with SSS is Three Thousand Five
Hundred(P3,500.00)Philippine Pesos;
129. My child Mary Jane Y. Escal intends to apply for loan with Paglaum
Multipurpose Cooperative;
130. I hereby undertake that I will allow, consent and authorize my said child
Mary Jane Y. Escal to utilize my monthly pension as collateral for theloan she
will contract or contracted with Paglaum Multipurpose Cooperative;
131. In the event I will not comply with this undertaking, I hereby authorize the
said ccoopetative to claim whatever balance of the obligation incurred from
my account;
132. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

ESTERLITA Y. ESCAL
(Affiant)
SSS ID#10-0565445-0
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AS HEIRS

We: ZURI MISCHA TARAN, YIESHA SUMMER TARAN, XYRIL CALEB

TARAN, all minors, and LESLIE M. TARAN, of legal age, Filipino, swidow, a resident
of Gulayon, Dipolog City Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That we are the heirs of CYRIL T. TARAN who was the heir of AVELINA
TUDTUD TARAN who had a bank account, more specifically described as follows:
CASH IN BANK at CHINA BANK-Banilad Cebu Branch with BANK
ACCOUNT NUMBER PHP1670815116;

That Avelina Tudtud Taran died and was survived by her heir/claimant Cyril T.
Taran;

That Cyril T. Taran also died intestate; That we undertake and declare that we are
the only heirs of Cyril T. Taran and we are entitled to the said account;

That we hereby authorized ANDRES TARAN to process, claim and withdraw the
bank account stated above and sign all papers necessary to release of the the cash in bank;

That for and in consideration of my/our receipt of the amount plus the accruing
interests, representing proceeds of said account(the “Account”). We hereby expressly
and absolutely remiss, release and forever discharge CHINABANK, its owners, directors,
stockholders, officers, employees and assignes from any and all claims, suits, actions or
causes of action which we, my/our succesors/assignes now have or in the future claims to
have against CHINABANK in connection with the Account;

That I/we hereby further obligate myself/ourselves, jointly and severally to

indemnify CHINABANK for any loss or damages which it may sustain in the event that
any third person/s shall succeed in establishing a right superior to that of mince/ours
concerning the Account.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of

September 2022, at Dipolog City, Philippines.

ZURI MISCHA TARAN/YIESHA SUMMER TARAN/ XYRIL CALEB TARAN

Represented by mother

LESLIE M. TARAN
(Affiant)
Driver’s License#J01-22-301244
With photo
 SUBSCRIBED AND SWORN to before me this ___ day of September 2022, at
Dipolog City.
Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That,we:ROSEWELYN J. CAYLAN, married to Jose Centino EVELYN J.

CAYLAN, married to Rolando Morados, LILIAN J. CAYLAN, married to Reynaldo
Cinco, SHAYNE ANTHONY CAYLAN, single; DUSTIN MAYLENE CAYLAN,
single; ARNOLD J. CAYLAN, married to Mercedes Urbiztondo; JAMES J. CAYLAN,
married to Neria Manogura;MERLYN J. CAYLAN, married to Ricardo Ayala;
FAROLITO J. CAYLAN, single; VILLALYN J. CAYLAN, single; all Filipinos, all of
legal age,, all residents of Dipolog City, Zamboanga del Norte,after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

347. We are the transferees of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 6247, situated at Diwan, Dipolog City,

Zamboanga del Norte, and covered by Transfer Certificate of Title No.(T-
13625)7433 issued by Register of Deeds for Dipolog City, containing total
area of (66,861) square meters”.
348. The above stated parcel of land is agricultural land;
349. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
350. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
351. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
352. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

SHAYNE ANTHONY CAYLAN DUSTIN MAYLENE CAYLAN

 (Affiant) (Affiant)
TIN#946-808-402 TIN#946-809-612

JAMES J. CAYLAN
(Affiant & Attorney-in-fact[AIF])
As AIF of Rosewelyn J. Caylan, Evelyn J. Caylan, Arnold J. Caylan, Merlyn J. Caylan,
Farolito J. Caylan, Willalyn J. Caylan, & Lilian J. Caylan)

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, STEPHEN LOUIS M. LIM, of legal age, Filipino, single/married, a

resident of Blk4, Lot 5, VCH, Obay, Polanco, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and say:

That I am the owner and driver of a motor vehicle, which is more

particularly described as follows;

MAKE: TOYOTA SERIES: VIOS 1.3 E GAS A

CR NO.:13738508-0 ENGINE NO:2NZ6023999
CHASSIS NO.NCP929047027

That,the said vehicle was involved in a vehicular incident that transpired on

September 10, 2022 at around or about 5:30 in the afternoon along National
Highway, Opao, Dapitan City with another vehicle;

That as result the above mentioned vehicle was impounded by the

Philippine National Police of Dapitan City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered in
my name to undersigned or my representative with the undertaking that I shall
make the same available to the Honorable Prosecutor or any authority in
connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of September 2022, at Dipolog City, Philippines.

STEPHEN LOUIS M. LIM

 (Affiant)
Driver’s License#J01-07-004088
With photo

SUBSCRIBED AND SWORN to before me this ___ day of September

2022, at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:JEROME ZAMORA y Atay, of legal age, single/married, Filipino, resident of

Napo, Dapitan City, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

353. I am the accused in the case titled People of the Philippines vs. Jorande G.
Legados, Criminal Case No.25790 pending before Regional Trial Court Branch
__, Dipolog City;
354. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
355. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
356. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

JEROME ZAMORA y Atay

(Affiant)
Valid ID#___________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 20ww, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

I:JORANDE G. LEGADOS, of legal age, married, Filipino, resident of

Dansullan, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

357. I am the accused in the case titled People of the Philippines vs. Jorande G.
Legados, Criminal Case No.24495 pending before Regional Trial Court Branch 7,
Dipolog City;
358. I hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against me and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
359. I hereby waive my right to be present during the trial in this case and the
Court may, therefore, proceed with the trial of this case even in my absence;
360. I am executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

JORANDE G. LEGADOS
(Affiant)
Valid ID#___________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 20ww, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING AND WAIVER OF APPEARANCE

We:MARY CRIS PONTANAR INSONG and WOWIE FRANCISCO

GUMANAS, both of legal age, both Filipinos, residents of [Link] St. Ext., Estaka,
Dipolog City and Miputak, Dipolog City, respectively,after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

361. We are the accused in the case titled People of the Philippines vs. Wowie
Gumanas y Francisco, Criminal Case No.21686 pending before Regional Trial
Court Branch 7, Dipolog City;
362. We hereby undertake to appear before the court whenever required by the
court to appear and in case of failure to appear, a warrant of arrest shall be issued
against us and the bond shall be confiscated relative to Rule 114 of the Revised
Rules of Criminal Procedure;;
363. We hereby waive our right to be present during the trial in this case and
the Court may, therefore, proceed with the trial of this case even in our absence;
364. We are executing this affidavit and waiver to attest to the truth of the
foregoing statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of September 2022, at Dipolog City, Philippines.

MARY CRIS PONTANAR INSONG

(Affiant)
Valid ID#___________________
With photo

WOWIE FRANCISCO GUMANAS

(Affiant)
Valid ID#________________________
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 20ww, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We:ELVIRA U. ELUNA and JONATHAN M. ELUMBARING, both

Filipinos, both of legal age, both single, both residents of Minaog,
Dipolog City, Zamboanga del Norte,after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following,
THAT:

365. We are the transferees of portion of parcel of land

more particularly described as follows:

“A parcel of land known as Lot 2644-B-2-B, PSD-09-

078672, situated at Minaog, Dipolog City, Zamboanga del
Norte, and covered by Transfer Certificate of Title
No.128-2020000569 issued by Register of Deeds for
Dipolog City, containing total area of (3,940) square
meters”.
366. The above stated parcel of land is agricultural land;
367. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
368. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
369. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
370. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

ELVIRA U. ELUNA JONATHAN M.

ELUMBARING
(Affiant) (Affiant)
ID#_____________________ ID#______________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We:EASTON STEELE G. GEIMAN, ZECHARIAH DAVID G. GEIMAN,

ELISHA JAMES G. GEIMAN, MADELINE GRACE G. GEIMAN, DARLENE
ESTHER G. GEIMAN, AND HANNAH RUTH G. GEIMAN, all minors, all
Filipinos, all single, all residents of Lingasad, Polanco, ZN represented
by father STEPHEN COLBYRN GEIMAN , an American citizen, of legal
age, widower, resident of Lingasad, Polanco, Zamboanga del
Norte,after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

371. We are the transferees of parcels of land more

particularly described as follows:

1.“A parcel of land known as Lot 2029-D-3-B, PSD-09-

047601, situated at Olingan(now Galas), Dipolog City,
Zamboanga del Norte, and covered by Transfer
Certificate of Title No.128-2016000276 issued by Register
of Deeds for Dipolog City, containing total area of (2,497)
square meters”.

2.“A parcel of land known as Lot 2029-D-3-A, PSD-09-

047601, situated at Olingan(now Galas), Dipolog City,
Zamboanga del Norte, and covered by Transfer
Certificate of Title No.128-2016000279 issued by Register
of Deeds for Dipolog City, containing total area of (2,496)
square meters”.

3. .“A parcel of land known as Lot 4431-A-1, PSD-09-

075054, situated at Lingasad, Polanco, Zamboanga del
Norte, and covered by Transfer Certificate of Title No.T-
88472 issued by Register of Deeds for ZN, containing total
area of (822) square meters”.

4. “A parcel of land known as Lot 2029-D-3-C, PSD-09-

047601, situated at Olingan(now Galas), Dipolog City,
Zamboanga del Norte, and covered by Transfer
Certificate of Title No.128-2016000279 issued by Register
of Deeds for Dipolog City, containing total area of (3,745)
square meters”.
 5. .“A parcel of land known as Lot 4432-B, PSD-09-
010198, situated at Lingasad, Polanco, Zamboanga del
Norte, and covered by Transfer Certificate of Title No.T-
88292 issued by Register of Deeds for Dipolog City,
containing total area of (38,301) square meters”.
372. The above stated parcels of land are agricultural lands;
373. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural landd use to some
other uses or purposes;
374. In the future, the transfereed will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
375. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
376. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

EASTON STEELE G. GEIMAN/ZECHARIAH DAVID G.

GEIMAN/DARLENE ESTHER G. GEIMAN/ HANNAH RUTH G.
GEIMAN/ELISHA JAMES G. GEIMAN/MADELINE GRACE G. GEIMAN

Represented by:

STEPHEN COLBURN GEIMAN

(Affiant)
ID#_____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
p

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT

I, MAPET C. GURDIEL, of legal age, Filipino, married, a resident of Lawaan,

Dapitan City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

377. I am a physician by profession and I engaged in medical practice as OB-

GYN specialist since 1999;
378. I owned a medical clinic situated along Echavez St., Dipolog City and
maintained a secretary to assist me in my clinic who processed and registered my
contributions at Home Development Mutual Fund(Pag-ibig);
379. I was offered a job in UAE which I accepted resulting to the closure of my
clince on December 17, 2017;
380. I resumed my practice sometime February 2021 after I returned from
UAEl
381. I hired another secretary who processed my contribution remittances at
Pag-ibig and as result my records at Pag-ibig appeared that there are two:
a. Dra. Mapet C. Gurdiel
b. Dr. Mapet C. Gurdiel
382. The said registrations refer to one and the same person and intend to
register one and the same person;
383. However these confusions were mistake committed by my secretary;
384. As such, I intend that Dra. Mapet C. Gurdiel and Dr. Mapet C. Gurdiel be
officially joined as one account name or registered name in the Pag-ibig;
385. I fully understand that any violation or any falsification or
misrepresentation of the information herein stated and in the documents I
submitted shall in the filing of the appropriate civil, criminal and/or administrative
complaint against me.
 386. I am executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

September 2022, at Dipolog City, Philippines.

MAPET C. GURDIEL
(Affiant)
PRC ID#0083024
With photo

SUBSCRIBED AND SWORN to before me this __th day of September 20ww, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, BIENVENIDA LOMOCSO, Filipino, of legal age, widow, resident of Minaog,

Dipolog City, Zamboanga del Norte,after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

387. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 2682-M, PSD-09-026401, situated at

Minaog, Dipolog City, Zamboanga del Norte, and covered by Transfer
Certificate of Title No.128-2018000815 issued by Register of Deeds for
Dipolog City, containing total area of (1,319) square meters”.
 388. The above stated parcel of land is agricultural land;
389. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
390. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
391. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
392. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

BIENVENIDA LOMOCSO
(Affiant)
ID#____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, REYNANTE C. ELUMBARING, Filipino, of legal age, single, resident of

VCH, Obay, Polanco, Zamboanga del Norte,after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

393. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 1885-B-2-D-5-G, PSD-09-062580,

situated at Obay, Polanco, Zamboanga del Norte, and covered by
 Transfer Certificate of Title No.128-201900oo936 issued by Register of
Deeds for Dipolog City, containing total area of (4,079) square meters”.
394. The above stated parcel of land is agricultural land;
395. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
396. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
397. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
398. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

REYNANTE I. ELUMBARING
(Affiant)
ID#____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, ALMA CHRISTINA M. CASTILLO, LAWRENCE ARTHUR M.

CASTILLO, KATRINA ANNE M. CASTILLO, all residents of 53 Marigold Cicrle,
Ladislawa Village, Davao City; MARIA ROSALINDA M. LAGERA, LUIS M.
LAGERA,JR., CLARENCE M. LAGERA, GEORGE M. LAGERA, PAMELA M.
LAGERA, FRANCIS EMMANUEL M. LAGERA,VANESSA MARIE M. LAGERA,all
preceding eight(8) represented by MILAGROS M. FRANCISCO, ZENAIDA F.
LAGERA, CIELO F. LAGERA, and CELESTE ANN LAGERA-BAUSTISTA, all with
Philippine residence of JEM Village, Ma-a, Davao City;all Filipinos, all of legal age,after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

399. We are the transferees of parcel of land more particularly described

as follows:

“A parcel of land known as Lot 2553, situated at Dipolog City,

Zamboanga del Norte, and covered by Transfer Certificate of Title
No.128-201400157 issued by Register of Deeds for Dipolog City,
containing total area of (27,070) square meters”.
400. The above stated parcel of land is agricultural land;
401. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
402. In the future, the transferees will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
403. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
404. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

ALMA CHRISTINA M. CASTILLO LAWRENCE ARTHUR M. CASTILLO

(Affiant) (Affiant)
ID#__________________________ ID#_________________________

KATRINA ANNE M. CASTILLO ZENAIDA F. LAGERA

(Affiant) (Affiant)
ID#_________________________ ID#_________________________

CIELO F. LAGERA CELESTE ANN LAGERA-BAUSTISTA

(Affiant) (Affiant)
ID#________________________ ID#__________________________

MARIA ROSALINDA M. LAGERA, LUIS M. LAGERA,JR., CLARENCE

[Link], GEORGE M. LAGERA, PAMELA M. LAGERA, FRANCIS
EMMANUEL M. LAGERA,VANESSA MARIE M. LAGERA
Represented by:

MILAGROS M. FRANCISCO
Attorney-in-fact
ID#___________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, VANESSA VILLEGAS MACASAET, Filipino, of legal age, widow, resident

of Sicayab, Dipolog City, Zamboanga del Norte,after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

405. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 2553, situated at Dipolog City,

Zamboanga del Norte, and covered by Transfer Certificate of Title
No.128-201400157 issued by Register of Deeds for Dipolog City,
containing total area of (27,070) square meters”.
406. The above stated parcel of land is agricultural land;
407. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
408. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
409. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
410. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

VANESSA VILLEGAS MACASAET

(Affiant)
Philhealth ID#14-050082930-7

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JEREMY PROTASIO BERCASIO MARAON II, Filipino, of legal age,

married, resident of Egot, Estaka, Dipolog City, Zamboanga del Norte,after having been
duly sworn to an oath in accordance with law, do hereby depose and say the following,
THAT:

411. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 1844-A-2-D, PSD-09-078234, situated at

Gulayon, Dipolog City, Zamboanga del Norte, and covered by Transfer
Certificate of Title No.128-201900oo936 issued by Register of Deeds for
Dipolog City, containing total area of (2,000) square meters”.
412. The above stated parcel of land is agricultural land;
413. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
414. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
415. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
416. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

JEREMY PROTASIO BERCASIO MARAON II

(Affiant)
ID#______________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, GEMMA O. PAPON, Filipino, of legal age, married, resident of New Sicayab,

Polanco, Zamboanga del Norte,after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

417. I am the transferee of portion of parcel of land more particularly

described as follows:

“A parcel of land known as Lot 7669-A, situated at Dansullan, Polanco,

Zamboanga del Norte, and covered by Original Certificate of Title P-
49845 issued by Register of Deeds for Zamboanga del Norte, containing
total area of (32,504) square meters”.
418. The above stated parcel of land is agricultural land;
419. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
420. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
421. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
422. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

GEMMA O. PAPON
(Affiant)
Philhealth ID#14-201257349-8

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, EDGAR M. AGAYAN, Filipino, of legal age, married, resident of Obay,
Polanco, Zamboanga del Norte,after having been duly sworn to an oath in accordance
with law, do hereby depose and say the following, THAT:

423. I am the transferee of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 6, PCS-09-003472, situated at Bandera,

Polanco, Zamboanga del Norte, and covered by Transfer Certificate of
Title T-70111 issued by Register of Deeds for Zamboanga del Norte,
containing total area of (1,382) square meters”.
424. The above stated parcel of land is agricultural land;
425. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
426. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
427. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
428. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

EDGAR M. AGAYAN
(Affiant)
TIN#182-971-129

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We: Spouses RODRIGO C. BAHI-AN,JR and FLOR G. BAHIAN, both

Filipinos, both of legal age, both residents of Tolon, Rizal, Zamboanga del Norte after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

429. We are the transferees of a parcel of land, to wit:

“A parcel of land known as Lot 1291-C, PSD-130938,
situated at Rizal, Zamboanga del Norte, and covered by
Transfer Certificate of Title T-37900 issued by Register of
Deeds for Zamboanga del Norte, containing total area of
(20,000) square meters”.

430. The above stated parcel of land are agricultural land;

431. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
432. In the future, the transferees will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City;
433. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against us.
434. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

RODRIGO C. BAHI-AN,JR/FLOR G. BAHI-AN

Affiants
PRC ID#0917424 PRC ID#0917425
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 We: MAJORIE A. ARELLANO, married; MA. VIOLETA [Link], married;
MAIDA A. BABALO, married; MITZI A. MANINDING, married;all of legal age, all
Filipinos, all residents of Dapitan City, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

435. We are the transferees of a parcel of land, to wit:

A.“A parcel of land known as Lot No.1 ,situated at Sinonoc, Dapitan
City, and covered by Transfer Certificate of Title No.T-57087 issued
by Register of Deeds for Dapitan City, containing an area of (66, 809)
square meters”.
B. “A parcel of land known as Lot No.269-A ,situated at Poblacion,
Dapitan City, and covered by Transfer Certificate of Title No.(T-
32908)2612 issued by Register of Deeds for Dapitan City, containing
an area of (299.5) square meters”.
436. The above stated parcels of land are agricultural land;
437. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
438. In the future, the transferees will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City;
439. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against us.
440. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

MAJORIE A. ARELLANO MA. VIOLETA A. HAMOY

(Principal) (Principal)
ID#_____________________ ID#_________________

MAIDA A. BABALO MITZI A. MININDING

(Principal) (Principal)
ID#___________________ ID#________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF DISCREPANCY

I, ANGELIKA ONTANAN NALIH, of legal age, Filipino, single, a

resident of Bagong Silang, Gutalac, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

My name and date of birth in the records of Jose Rizal Memorial State
University(JRMSU) was indicated as ANGELICA ONTANAN NALIH and March 12,
1998, respectively;

My true and correct name and date of birth are ANGELIKA ONTANAN NALIH and
August 5, 1996, respectively. These are supported by public record/s;

The mistake in indicating my correct name and date of birth was due to the fact that there
was mistake in my high school records which was carried in the JRMSU;

That Angelica Ontanan Nalih with date of birth of March 12, 1998 and Angelika Ontanan
Nalih with date of birth of August 5, 1996 refer to one and the same person;

I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

ANGELIKA ONTANAN NALIH

(Affiant)
Brgy Bagong Silang, Gutalac,ZN ID#02429
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT

I, CORA LYDWIN MONTALLANA, of legal age, Filipino, married,

a resident of Gulayon, Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and state:

That I am an employee of Land Registration Authority, Register of Deeds for Zamboanga

del Norte with the position of Examiner;

That I applied for a vaction leave for the period August 15 to September 9, 2022 or 26
calendar days;

That I and my family intend to travel to Australia on the said dates;

That no government funds is involved in connection with said travel and my family has
already purchased round trip tickets sponsored by my daughter;

That my leave of absence will not hinder the operation of the Register of Deeds for
Zamboanga del Norte and I hereby undertake to report back to the office after the end of
my leave of absence;

That I have no pending administrative case or criminal case nor having charged of neither
found guilty of any said case;

That within three(3) days upon arrival I will furnish the Land Registration Authority a
photocopy of my passport duly stamped by the Bureau of Immigration.

I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

CORA LYDWIN MONTALLANA

(Affiant)
OFFICE ID#1209DPL014
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at

Dipolog City.

Doc. No. 2196

Page No. 07
Book No. XVI
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF CIVIL STATUS

I, JOSE PAOLO B. CRUZ, of legal age, Filipino, single, a resident of

Obay, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

133. I am the vendee a parcel of land covered by OCT No.P-3985 situated

at Buenasuerte, Mutia, Zamboanga del Norte;
134. My civil status is “single”;
135. I have not been married to any woman;
136. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2022, at Dipolog City, Philippines.

JOSE PAOLO B. CRUZ

(Affiant)
Driver’s License#J01-08-001888
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

SWORN UNDERTAKING

I, GLEN FOR F. MAHAWAN, of legal age, Filipino, single, a resident of

Poblacion, Sibutad, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

137. I am an employee of Inframachineries Corporation(Inframachineries

for brevity), with office address of Mamplasan, Binan City, Laguna;
138. I am the authorized representative of said corporation in all
transactions before the Local Government Unit of Zamboanga del
Norte;
139. Inframachineries is the supplier of machinery/equipment with total
contract amount of P13,760,000.00 to Local Government Unit of
Zamboanga del Norte;
140. Inframachineries delivered the items to the said LGU and the latter
issued Landbank of the Philippine Check with number 0002640990 in
the amount of P12,885,257.15 as payment for the delivered items after
withholding taxes;
 141. However, due to mistake and failure to consider the withholding
taxes, Inframachineries issued a receipt in the amount P13,760,000.00;
142. Thus, I hereby undertake that I will replace the receipt with the
correct amount of P12,885,257.15 in favor of the LGU in view of the
issuance of the said check to the corporation;
143. In the event I will not comply with this undertaking, I hereby
authorize the said LGU to hold me liable in whatever nature;
144. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th

day of __________ 2022, at Dipolog City, Philippines.

GLEN FORD F. MAHAWAN

(Affiant)
Driver’s License#J01-19-000980
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, GENEVIEVE B. MIRANDA, of legal age, Filipino, married, a

resident of Punta, Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

145. I am currently employed by Department of Education-Dipolog City

Division;
 146. I transferred my employment from Department of Education assigned at
Zamboanga del Norte Division Office;
147. I am an applicant for loan or has an existing loan with the DepEd-
Zamboanga del Norte Division Office
148. I utilize my employment as security on my said application for loan before
the City Savings Bank;
149. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new work assignment even after the transfer at DepEd-
Dipolog City Division;
150. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
151. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

GENEVIEVE B. MIRANDA
(Affiant)
PRC ID#0930867
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, MARY JANE G. MEDICI, of legal age, Filipino, single/married, a
resident of Miputak, Dipolog City, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the owner and driver of a motor vehicle, which is more

particularly described as follows;

MAKE: HONDA SERIES: ACH110CSFL

CR NO.:0601-00000967510 ENGINE NO:JF78E7289751
CHASSIS NO.K81N1023202

That,the said vehicle was involved in a case docketed as Criminal Case No.
[Link] NOS. 24013 & 24014 before Regional Trial Court-Branch 8,
Dipolog City.

That as result the above mentioned vehicle was impounded by the

Philippine National Police of Dipolog, Zamboanga del Norte;
That however the said motor vehicle was not submitted to court as part of
prosecution’s evidence hence it is still under authority of the Philippine National
Police;
That the abovementioned cases were already decided and disposed of after
accused entered plea bargaining, hence, the said motor vehicle is ready for release
to undersigned or representative;

That I hereby request for the release of the said motor vehicle registered in
my name to undersigned’s representative with the undertaking that I shall make
the same available to the Honorable Prosecutor or any authority in connection with
any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __

day of June 2022, at Dipolog City, Philippines.

MARY JANE G. MEDICI

(Affiant)
ID#______________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of June 2022, at

Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JAY RALPH B. NAQUILA, of legal age, Filipino, married, a resident of

VCH, Obay, Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner and driver of a motor vehicle, which is more

particularly described as follows;

MAKE: HONDA SERIES: CIVIC

PLATE NO.:KDN-404 ENGINE NO:RNGD01-7100949
CHASSIS NO.PADFD15107V100943

That,the said vehicle was involved in vehicular accident on June 3, 2022 at

around or about 7:55 in the morning in National Highway Sicayab, Dipolog
City,while travelling towards Dapitan City.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation
involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3rd

day of June 2022, at Dipolog City, Philippines.

JAY RALPH B. NAQUILA

(Affiant)
Driver’s License#J01-98-026604
With photo

SUBSCRIBED AND SWORN to before me this 3rd day of June 2022, at

Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, CONNIE G. ANTIVO, married, and RHEA A. GALLEMIT, single; both of

legal age, both Filipinos, and both residents of Magangon, Polanco, Zamboanga del Norte
after having been duly sworn to an oath in accordance with law, do hereby depose and
state, that:

441. We are the transferees of a parcel of land, to wit:

“A parcel of land known as Lot No. 557-D,Psd-09-061455 situated at
Magangon, Polanco, Zamboanga del Norte, and covered by Transfer
Certificate of Title No. T-80814 issued by Register of Deeds for
Zamboanga del Norte, containing an area of (19,000) square meters”.
442. The above stated parcel of land is agricultural land;
443. The area purchased/inherited classified as agricultural land, we warrant
not to change the actual use of the property from agricultural land use to some
other uses or purposes;
444. In the future, the transferees will decide to change its use from agricultural
to residential, commercial or industrial, we undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City;
445. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against us.
446. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2022, at Dipolog City, Philippines.

CONNIE G. ANTIVO
(Affiant)
ID#___________________

RHEA A. GALLEMIT
(Affiant)
ID#___________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JULIETA M. DARUNDAY, married, of legal age, Filipino, and resident of

Situbo, Sergio Osmena, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

447. I am the transferee of a parcel of land, to wit:

“A parcel of land known as Lot No. 1755,Pls-5 situated at Sibulan,
Pinan, Zamboanga del Norte, and covered by Transfer Certificate of
Title No. T-45411 issued by Register of Deeds for Zamboanga del Norte,
containing an area of (37,429) square meters”.
448. The above stated parcel of land is agricultural land;
449. The area purchased/inherited classified as agricultural land, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
450. In the future, the transferee will decide to change its use from agricultural
to residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
451. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
452. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcel of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

JULIETA M. DARUNDAY
(Affiant)
OSCA ID#SO.20-108-Sergio Osmena,ZN
SUBSCRIBED AND SWORN to before me this ___ day of _________
2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ELWIN C. MARANE, of legal age, Filipino, single/married, with office

address of EMCOR Bldg., Tabuktulay, Minaog, Dipolog City, after having been
duly sworn to an oath in accordance with law, do hereby depose and say:

That I am the representative of Commercial Trade Financial Services, Inc.,-

Dipolog City;

That my employer is the financing company of motor vehicle, which is

more particularly described as follows;

MAKE: HONDA CHASSIS NO.K81N5018440

ENGINE NO.:JF78E7377258 COLOR:WHITE
BODY TYPE:MOTORCYCLE

That a certain Randy Q. Bait-it was the purchaser on installment basis of

the said motor vehicle;

That however Mr. Randy Q. Bait-it was arrested by police authority with
the motor vehicle confiscated during his arrest;

That said instance also, the above mentioned vehicle was impounded by the
Philippine National Police of Mutia, Zamboanga del Norte;

That the vehicle was not submitted to court as part of its evidence, hence it
can be released from impoundment;

That I hereby request for the release of the said motor vehicle to the
undersigned with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation
involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 18th

day of May 2022, at Dipolog City, Philippines.

ELWIN C. MARANE
(Affiant)
Driver’s License#J09-04-008875
With photo

SUBSCRIBED AND SWORN to before me this 18 th day of May 2022, at

Dipolog City.
Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CHARIZA L. ADORIO, Filipino, of legal age, Filipino, single, a resident of

[Link], Dipolog City, Zamboanga del Norte, Philippines, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

[Link] I have a pending application for business permit before the Local
Government Unit of Dipolog City;

2. That I hereby undertake to cease and desist from operating and opening my
said business pending approval of my application for business permit;

3. That I hereby further undertake that I will abide and follow the provisions of
City Ordinance No. 96-001 of Dipolog City and other ordinances, laws, rules, and
regulations pertaining to the regulation of the distribution/dispensing of any alcoholic
beverages;

4. That this is in compliance with the City Ordinance No. 96-001 of Dipolog City;

5. that I recognize the authority of the City License and Permits Division of
Dipolog City to revoke, suspend, and cancel our business permit in the event of any
violation to this undertaking without prejudice to any legal action that the said office may
files against the undersigned;

6. That I execute this affidavit of undertaking to attest the aforementioned

statements and be bound to all legal aspects under the laws of the Philippines
.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2022, at Dipolog City, Philippines.
 CHARIZA L. ADORIO
(Affiant)
VIN#7202-0220A-A0478CLA20000-0
With photo

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City.

Doc. No.
Page No.
Book No.
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

SWORN UNDERTAKING

I, ZAMBOANGA PENINSULA TRANSPORT

COOPERATIVE(ZAMPENTRANSCO), represented by RONILO C. ALTARIBA,
Filipino, of legal age, Filipino, a resident of Polanco, Zamboanga del Norte, Philippines,
after having been duly sworn to an oath in accordance with law, do hereby depose and
say:
That I am an applicant for the issuance of consolidated issuance of Provisional
Authority of Certificate of Public Convenience for the operation of following Filcab Mini
Jitney, to wit:

NAME OF CASE MAKE MOTOR NO. CHASSIS NO. PLATE NO.

OPERATOR NO.
Aproniano B. 2014- ISUZU 4HFI192375 NKR66E7100703 JVH-625
Andalahao 09-
00513
Divina O. 2010- SUZUKI F6A331296 DC51T-409307 Temp.090809
Borden 09-
00229
Domingo G. 2008- MITSUBISHI 4D31438163 LTO7R2140 JVL-199
Dy,Jr. 09-
00315
Julito and 2004- SUZUKI F6A5337025 DA51V282719 JVJ-847
Judith 09-
Barlaan 00204
Elena 2014- SUZUKI F6A-6588154 DC51T-14054 Temp.
Marabulas 09- 092803
00534
Cresencia C. 2014- SUZUKI 5084155 DA51V-257297 Temp.090809
Belocura 09-
00470
Elvie R. 89-09- MITSUBISHI 4D31426861 MUQ4YP882290 KAT-790
Abrasado 01713
Bryan I. 2016- NISSAN YD233388717A JNITC2E220006455 Temp.090802
Cenas 09-
00115
Romelito M. 2015- MITSUBISHI 231586 LTOR9C2793 Temp.090805
Bagatua 09-
00071
Nestor 2014- TOYOTA IKD2782546 JTFJ02PH5014378 KAB-4420
Decierdo 09-
00538
That I hereby undertake to comply on the substitution of old/existing units
reckoned from date of issuance/expiration of provisional authority in compliance to the
requirements for extension of Provisional Authority to the above-said franchises, based
on the applicable period:

6 months 25% of the total number of authorized units

9 months 50% of the total number of authorized units
12 months 100% of the total number of authorized units
That I execute this affidavit of undertaking to attest the aforementioned
statements and be bound to all legal aspects under the laws of the Philippines
IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day
of _____ 2022, at Dipolog City, Philippines.

ZAMBOANGA PENINSULA TRANSPORT COOPERATIVE(ZAMPENTRANSCO)

(Affiant)
Represented by:

RONILO [Link]
ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF RELEASE AND QUITCLAIM WITH INDEMNITY

UNDERTAKING

We: HEIRS OF TRUMAN C. SORRONDA, namely: CLYDE T. SORRONDA,

married; RYAN T. SORRONDA, single;and, JOJIT T. SORRONDA, married; all
residents of Turno, Dipolog City;[Link] C. SORRONDA, single, resident of Turno,
Dipolog City; [Link] OF CONCEPCION S. DALMAN, named VIVIAN D.
BHAGWANI, married, resident of Paranaque City; [Link] OF NIEVES S. BUENO,
namely: ALMA B. SINDO, single, resident of Lorenzo Garden Ville, Dipolog City;
CHARITO B. GUANTERO, married to Joseph Guantero, resident of Victoria Hills, Pob.
North, Polanco, Zamboanga del Norte; [Link] OF DRONICO C. SORRONDA,
namely: ADELFA S. TRANI, married to Albert Trani, resident of Igot, Dipolog City;
ALLAN L. SORRONDA, married to Sally Sorronda, resident of Igot, Turno, Dipolog
City; [Link] OF JOVENCIA S. SALDIA, namely: ARSENIO S. SALDIA, married to
Ma. Teresa P. Lluch, resident of Purok 10, Barangay Saray, iligan City; 7. HEIR OF
ANTONIO SORRONDA, named HEIDI S. SORRONDA-ADASA, married, resident of
Sicayab, Dipolog City; all of legal age; all Filipinos, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:
1. We are the heirs of the deceased NORMA C. SORRONDA who died intestate
on September 09, 2017 atat ZN Cooperative Hospital, Turno, Dipolog City,
Zamboanga del Norte(the Deceased);
2. For and in consideration of my/our receipt of the amount of Php473,976.81
plus the accruing interests, representing proceeds of PESO SAVINGS
ACCOUNT NO.003130138697 of the Deceased with BDO Unibank, Inc,-
Quezon Avenue Branch(the “Account”). We hereby expressly and absolutely
remiss, release and forever discharge BDO Unibank, Inc, its owners, directors,
stockholders, officers, employees and assignes(collectively, “BDO”)from any
and all claims, suits, actions or causes of action which we, my/our
succesors/assignes now have or in the future claims to have against BDO in
connection with the Account.
3. I/we hereby further obligate myself/ourselves, jointly and severally to
indemnify BDO for any loss or damages which it may sustain in the event that
any third person/s shall succeed in establishing a right superior to that of
mince/ours concerning the Account.

FURHTER AFFIANT/S SAYETH NAUGHT.

CLYDE T. SORRONDA RYAN T. SORRONDA JOJIT T. SORRONDA

(Affinat) (Affiant) (Affiant)

ERMA C. SORRONDA ALMA SINDO CHARITO GUANTERO

(Affiant) (Affiant) (Affiant)

ADELFA TRANI ARSENIO S. SALDIA

(Affiant) (Affiant)

ADELFA S. TRANI ERMA C. SORRONDA

For and in behalf Allan Sorronda For and in behalf of Vivian Bhagwani

JOJIT T. SORRONDA
For and in behalf of Heidi S. Adasa

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

SWORN UNDERTAKING
 I, ZAMBOANGA PENINSULA TRANSPORT
COOPERATIVE(ZAMPENTRANSCO), represented by RONILO C. ALTARIBA,
Filipino, of legal age, Filipino, a resident of Polanco, Zamboanga del Norte, Philippines,
after having been duly sworn to an oath in accordance with law, do hereby depose and
say:
That I am an applicant for the issuance of consolidated issuance of Provisional
Authority of Certificate of Public Convenience for the operation of following PUJ with
R9-CC-PJ-2020-LCASE NO.2020-09-00013, to wit:

NAME OF YM MAKE MOTOR NO. CHASSIS PLATE

OPERATOR NO. NO.
Aquila D. - TOYOTA D4BXP546034 MUQ2SB- JVH-697
Bustaliño 37720
Julie S. 2005 SUZUKI F6A-5907847 DC51T- JVL-457
Sedrome 229340
Roger P. 1994 NISSAN 555129 LTOR9C2358 JAY-233
Panama
Richard E. 2005 SUZUKI F6A-5016733 DC51T- JVK-157
Rengquijo,Jr 139867
Joel T. 2006 SUZUKI F6A5543824 DC51T- JVH-622
Ochotorena 110898
Edilberto C. 1999 MITSUBISHI 4D56EM2022 L039F- JVE-437
Saga 0051066
Danilo S. - NISSAN SD23-232074 SV-1555477 JVE-483
Cantores
Merlyn S. 1994 NISSAN SD23-216252 LTO-R9-C- JVA-955
Cadano 2843
Rolando D. 1996 NISSAN 4DR5216951 LTO-R9-C- JVL-452
Itok 4025
Josephine - SUZUKI F6A5684247 DJ51T105995 JVL-550
Tubio
[Link] 1994 SUZUKI 299950 LTO-R9-2689 JVB-126
R.
Rengquijo,Jr
and Jenniefer
A. Rengquijo
Zachary S. 2020 SUZUKI F6A-5486872 DC51T- -
Hamoy 100352
Andres 2012 SUZUKI F6A6395438 DC51T- 090801
Gebone 423175
Jundie 2010 SUZUKI F6A06490235 DC551T- 092602
Vallecer 445898
Roelyn Bicoy 2010 SUZUKI F6A-6667998 DC51T- 090803
Quizo 532611
That I hereby undertake to comply on the substitution of old/existing units
reckoned from April 1, 2022 in compliance to the requirements for extension of
Provisional Authority to the above-said franchises, based on the applicable period:

6 months 25% of the total number of authorized units

9 months 50% of the total number of authorized units
12 months 100% of the total number of authorized units
That I execute this affidavit of undertaking to attest the aforementioned
statements and be bound to all legal aspects under the laws of the Philippines
IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day
of _____ 2022, at Dipolog City, Philippines.
ZAMBOANGA PENINSULA TRANSPORT COOPERATIVE(ZAMPENTRANSCO)
(Affiant)
Represented by:

RONILO [Link]
ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

SWORN UNDERTAKING

I, ZAMBOANGA PENINSULA TRANSPORT

COOPERATIVE(ZAMPENTRANSCO), represented by RONILO C. ALTARIBA,
Filipino, of legal age, Filipino, a resident of Polanco, Zamboanga del Norte, Philippines,
after having been duly sworn to an oath in accordance with law, do hereby depose and
say:
That I am an applicant for the issuance of consolidated issuance of Provisional
Authority of Certificate of Public Convenience for the operation of following Filcab Mini
Jitney, to wit:

NAME OF CASE NO. MAKE MOTOR CHASSIS NO. PLATE

OPERATOR NO. NO.
Edgardo J. 2001-09- SUZUKI 5099126 DB411-219323 JVJ-121
Ernal 00667
Jaime B. 2014-09- SUZUKI 5151357 DA71V-117643 JVJ-846
Heyrana 00189-A
Richard C. 2004-09- SUZUKI 5611075 DC51T419455 JVJ-832
Tulabing 00227-A
Leonifa D. 2002-09- SUZUKI 2217269 LTO069173 JVJ-124
Nayal 00004
Maribeth B. 2005-09- SUZUKI F6A- DA51T-180666 JVK-120
Penaflor 00204 5388190
Sheryl L. 2011-09- SUZUKI F5A- DA71T-344546 JVE-554
Arabia 00231 2635323
Benjamin P. 2015-09- SUZUKI F6A- DC51T-426762 JVK-162
Tanghal 00246 6408631
Glades Aves 2014-09- SUZUKI F5A- DA71T-161233 JVC-813
00096 1968158
Alexander 97-09-00217 SUZUKI 2691871 DA71T339562 JVD-143
Curado
That I hereby undertake to comply on the substitution of old/existing units
reckoned from April 1, 2022 in compliance to the requirements for extension of
Provisional Authority to the above-said franchises, based on the applicable period:

6 months 25% of the total number of authorized units

9 months 50% of the total number of authorized units
12 months 100% of the total number of authorized units
That I execute this affidavit of undertaking to attest the aforementioned
statements and be bound to all legal aspects under the laws of the Philippines
IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day
of _____ 2022, at Dipolog City, Philippines.

ZAMBOANGA PENINSULA TRANSPORT COOPERATIVE(ZAMPENTRANSCO)

(Affiant)
Represented by:

RONILO [Link]
ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RACHEL CABUGNASON BASIS, Filipino, of legal age, Filipino, married, a

resident of Victoria County Homes, Obay, Polanco, Zamboanga del Norte, Philippines,
after having been duly sworn to an oath in accordance with law, do hereby depose and
say:

That I am an applicant for issuance of Philippine Passport;

That upon submission of documents, I found out that my Certificate of Live Birth
indicated that I was born in Dapitan City however in my Certificate of Marriage, it
appeared that I was born in Dipolog City;

That there is error in my Certificate of Marriage as my correct place of birth is

Dapitan City;

That I hereby undertake to file for correction of my Certificate of Marriage’s

record of my place of birth from Dipolog City into Dapitan City;

That I will present the annotated document on future renewal of passport;

That I agree that my name will be included in the DFA’s watchlist;

That I execute this affidavit of undertaking to attest the aforementioned

statements and be bound to all legal aspects under the laws of the Philippines
.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2022, at Dipolog City, Philippines.

RACHEL CABUGNASON BASIS

(Affiant)
ID#_________________
With photo
 SUBSCRIBED AND SWORN to before me this ___ day of ____ 2022, at
Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ARIS JAN J. LOZADA, of legal age, Filipino, married, a

resident of Purok Cacao, Minaog, Dipolog City, after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

152. I am currently employed by Local Government Unit of Sibutad,

Zamboanga del Nore;
153. I transferred my employment from Department of Education assigned at
Dipolog City Division Office;
154. I am an applicant for loan or has an existing loan with the DepEd-Dipolog
City(Provident);
155. I utilize my employment as security on my said application for loan before
the said bank;
156. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new work assignment even after the transfer at LU-
Sibutad, Zamboanga del Norte ;
157. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
158. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2022, at Dipolog City, Philippines.

ARIS JAN J. LOZADA

(Affiant)
Driver’s License#J01-97-024381
With photo
 SUBSCRIBED AND SWORN to before me this __th day of _________ 2022, at
Dipolog City.

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, FORTUNATO A. MAGHINAY,JR, of legal age, Filipino, single, a

resident of San Francisco, Dapitan City, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: YAMAHA CR NO.:38883175-2

SERIES:MIO I MV FILE NO.0908-00003357334
ENGINE NO.:E3W6E-0229245 YEAR MODEL:2019
BODY TYPE:MC

That,the said vehicle was object of carnapping and the carnappers were
apprehended at Turno, Dipolog City.

That said instance also, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle to the
undersigned with the undertaking that I shall make the same available to the
Philippine Coconut Authority/Honorable Prosecutor or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 23rd

day of March 2022, at Dipolog City, Philippines.
 FORTUNATO A. MAGHINAY,JR
(Affiant)
Driver’s License#J01-20-004595
With photo

SUBSCRIBED AND SWORN to before me this 23rd day of March 2022,

at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2022

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LEOPOLDO C. HERNANE, of legal age, Filipino, widow, a resident of

Cogon, Ozamiz City, Misamis Occidental, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle, which is more particularly

described as follows;

MAKE: FUSO CR NO.:42528023-6

PLATE NO.:MDQ3717 MV FILE NO.1201-00000164473
ENGINE NO.:8M20-001965 CHASSIS NO.:FU54JLIZ520374
BODY TYPE:WINGVAN YEAR MODEL:2014

That,the said vehicle was utilized to transport coco lumber while permits
were secured at Philippine Coconut Authority however it was impounded after it
was discovered that transport permit is fake on February 10, 2022 at around or
about 1:30 in the afternoon while processing for embarking and loading at Pulauan
Port, Dapitan City.

That on the same date, the above mentioned vehicle was impounded by the
Philippine Coconut Authority/Philippine National Police of Dapitan City,
Zamboanga del Norte;
 That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Philippine Coconut Authority/Honorable Prosecutor or any authority in connection
with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 11th

day of February 2022, at Dipolog City, Philippines.

LEOPOLDO C. HERNANE
(Affiant)
TIN ID#179-179-638
With photo

SUBSCRIBED AND SWORN to before me this 11th day of February

2022, at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, BIENVENIDO S. CULANCULAN, married, of legal age, Filipino, and resident

of Disakan, Manukan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

453. I am the buyer of the following parcels of land:

a.) “A parcel of land known as Lot No. 1-B, Psd-09-054216 situated at
Disakan, Manukan, Zamboanga del Norte, and covered by Transfer
Certificate of Title No. T-85994 issued by Register of Deeds for
Zamboanga del Norte, containing an area of two thousand nine hundred
seventy-eight (2,978) square meters”.
b.) “A parcel of land known as Lot No. 5, Pcs-09-004292 situated at
Disakan, Manukan, Zamboanga del Norte, and covered by Transfer
Certificate of Title No. T-85993 issued by Register of Deeds for
Zamboanga del Norte, containing an area of one thousand forty-two
(1,042) square meters”.
 454. The above stated parcels of land are agricultural land
455. The area purchased/inherited classified as agricultural lands, I warrant not
to change the actual use of the property from agricultural land use to some other
uses or purposes;
456. In the future, the buyer will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
457. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
458. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2022, at Dipolog City, Philippines.

BIENVENIDO S. CULANCULAN
(Affiant)
OSCA ID#MAN-15-676-Manukan,ZN

SUBSCRIBED AND SWORN to before me this ___ day of _________

2022, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MA. MICHAELLA ISABEL N. LUAYON, of legal age, Filipino,

single, a resident of Estaka, Dipolog City, Zamboanga del Norte, after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

459. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City.
460. I applied to claim my terminal leave benefits and all other claims from the
hospital;
461. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demandable.
462. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

MA. MICHAELLA ISABEL N. LUAYON

(Affiant)
PRC ID#0150503
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2020, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HANNAH LYN D. GUMAPON, of legal age, Filipino, single, a

resident of Poblacion South, Polanco, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

463. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City.
464. I applied to claim my terminal leave benefits and all other claims from the
hospital;
465. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demandable.
466. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

HANNAH LYN D. GUMAPON

(Affiant)
PRC ID#0143673
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2020, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF SUPPORT AND UNDERTAKING

I, HENRY R. ARCADIO, of legal age, Filipino, married, resident of

Malvar St., Miputak, Dipolog City, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state,
that:

467. I am the father of HUBERT JOHN P. ARCADIO, a resident of

Santa Isabel, Dipolog City;
468. My said son Hubert John P. Arcadio applied for Motorized
Tricycle Operator’s Permit(MTOP) before City Government of
Dipolog City for his motor vehicle with the following details:
MAKE: Kawasaki CR No. 39499616-2
ENGINE NO.:BC175AELC3545 CHASSIS NO.:BC175H-
B04492
SERIES:BC175H BODY TYPE:MC W/
SIDECAR
469. My said child has no permanent job or work which is a
requisite to prove his financial capacity;
470. With that consideration, I hereby undertake to provide financial
support in his application for MTOP before the City Government of
Dipolog City;
471. In the event, there will financial liability that will occur in
relation to the operation of the MTOP I hereby further undertake to
support my said child in his liability or obligation that may arise;
472. I am executing this affidavit to attest to the truth of the
foregoing statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

__th day of ___________2021, at Dipolog City, Philippines.

HENRY R. ARCADIO
(Affiant/AIF)
Driver’s License#J01-95-018315
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________

Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, BENJIE T. DIHAYCO, of legal age, Filipino, single, a resident of

Letapan, Polanco, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle, which is more particularly

described as follows;

MAKE: HONDA COLOR:RED

PLATE NO.:TEMPORARY
09083358993

That,the said vehicle was involved in vehicular accident on September 12,

2021 at around or about 6:00 in the evening while traversing Canibongan,
Villahermosa, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation
involving it anytime.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this 17th
day of September 2021, at Dipolog City, Philippines.

BENJIE T. DIHAYCO
(Affiant)
ID#____________________

SUBSCRIBED AND SWORN to before me this 17th day of September

2021, at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ALTON ERAMIS VELASCO, of legal age, Filipino, married, a resident

of Gulayon, Dipolog City, Zamboanga del Norte, after having been duly sworn to
an oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle registered under the name of

Polanco LGU, which is more particularly described as follows;

MAKE: TOYOTA Engine No.1GD0744844

SERIES;HI-LUX Chassis No.MR0HABCD6K1009521
PLATE NO.:PA-P170

That,the said vehicle was involved in vehicular accident on August 31,

2021 at around or about 4:00 in the afternoon while traversing Lapu-lapu [Link]
Echavez St. Extension, Estaka, Dipolog City.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;
 That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation
involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 31th

day of August 2021, at Dipolog City, Philippines.

ALTON E. VELASCO
(Affiant)
Driver’s License#J01-09-002751

SUBSCRIBED AND SWORN to before me this 31st day of August 2021,

at Dipolog City.

Doc. No.
Page No.
Book No
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, SAHRELOU L. LERIN, of legal age, Filipino, single, a resident

of Miputak, Dipolog City, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

159. I am currently employed by Department of Education assigned at

Zamboanga del Norte Division Office;
160. I am an applicant for loan or has an existing loan with the UCPB Savings
Bank, Dipolog City Branch;
161. However, I am transferring my assignment at Department of Education-
Dipolog City Division Office;
162. There is no change in employment but just a transfer of assignment;
163. I utilize my employment as security on my said application for loan before
the said bank;
 164. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new area of assignment even after the transfer at
Department of Education-Dipolog City Division Office ;
165. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
166. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

SAHRELOU L. LERIN
(Affiant)
PRC ID#1454759 valid until 8/29/2022
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARIEJESIE S. INDUS, of legal age, Filipino, widow, a resident of

Cogon, Dipolog City, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle more particularly described as

follows;

MAKE: HONDA Engine No.XRM16E072123

Series: CFT125A Chassis No.XRM16072118
MV File No.0908-00003313080 Plate No.3183JM

That,the said vehicle was carnapped on August 27, 2021 and it was
recovered on August 29, 2021 by Philippine National Police,Dipolog City Station.

That on the same date, the above mentioned vehicles were impounded by
the Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to
my name with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation
involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____

day of _____ 2021, at Dipolog City, Philippines.

MARIEJESIE S. INDUS
(Affiant)
Philhealth ID#14-025248228-4

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2021, at

Dipolog City.
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That, I, RODOLFO T. OCHOTORENA, of legal age, Filipino, married, resident of

[Link], Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

I am the transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 4,CCS-09-05-000008-D(Identical to Lot

4169,Pls-578, situated at Pedagan, Sergio Osmena, Zamboanga del
Norte, and covered by Katibayan ng Orihinal na Titulo Blg. P-34434
issued by Register of Deeds for ZN, containing an area of (27,740) square
meters”.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

RODOLFO T. OCHOTORENA
(Affiant)
TIN# 141-705-161

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.
Doc. No.___
Page No.____
Book No.__
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MELANIE P. BUSCA, of legal age, Filipino, a resident of

Dipolog City, after having been duly sworn to an oath in accordance with law, do
hereby depose and state, that:

167. I am currently employed by Department of Education assigned at

Zamboanga del Norte Division Office;
168. I am an applicant for loan or has an existing loan with the Katipunan
Bank, Dipolog City;
169. However, I am transferring my assignment at Department of Education-
Dipolog City Division Office;
170. There is no change in employment but just a transfer of assignment;
171. I utilize my employment as security on my said application for loan before
the said bank;
172. I hereby undertake that I will continue to pay my loan and allow/consent
salary deduction at my new area of assignment even after the transfer at
Department of Education-Dipolog City Division Office ;
173. In the event I will not comply with this undertaking, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
174. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

MELANIE P. BUSCA
(Affiant)
PRC ID#1120607
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That, I, ELMER F. DUMPA, of legal age, Filipino, married to Marites Dumpa, resident
of Biayon, Sergio Osmena, Zamboanga del Norte after having been duly sworn to an oath
in accordance with law, do hereby depose and say the following, THAT:

I am the transferee of portion of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 4477-B-2, situated at Poblacion Alto,

Sergio Osmena, Zamboanga del Norte, and covered by Transfer
Certificate of Title No. T-85587 issued by Register of Deeds for ZN,
containing an area of (8,164) square meters”.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.
 ELMER F. DUMPA
(Affiant)
SSS ID#10-0763336-9

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

I, DAYLINDA D. ICAO, of legal age, Filipino, married to Antonio Icao, resident of

Dansullan Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

I am the transferee of portion of parcel of land more particularly described as

follows:

“A parcel of land known as Lot 7546-A, situated at Dansulla, Polanco,

Zamboanga del Norte, and covered by Transfer Certificate of Title No. T-
74316 issued by Register of Deeds for ZN, containing an area of (21,870)
square meters”.
The above stated parcel of land is agricultural land .
I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

DAYLINDA D. ICAO
(Affiant)
ID#_________________

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, FILOMENO S. TAMONAN, of legal age, Filipino, married, a

resident of Lot 2,Blk 21 VCH, Obay, Polanco, Zamboanga del Norte,
after having been duly sworn to an oath in accordance with law, do hereby depose and
state, that:

175. I am currently sixty(60) years old and employed by Department of

Education assigned at Zamboanga del Norte National High School, Dipolog
City;
176. The said age is a retirable age;
177. I am an applicant for loan before the City Savings Bank, Dipolog City;
178. I utilize my employment as security on my said application for loan before
the said bank;
179. I hereby undertake that I will retire from my employment on the age of
sixty-five(65) years old;
180. In the event I will retire earlier than the said age, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account or claim;
181. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.
FILOMENO S. TAMONAN
(Affiant)
UMID ID#CRN-006-0127-0492-9
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF NO EXISTING SCHOLARSHIP GRANT

I, NESTLE J. DITAY, of legal age, Filipino, single, a resident of

[Link] St Extension, Estaka, Dipolog City, after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

I am an applicant at Mindanao State University- College of Medicine;

I have been accepted in the said College of Medicine;

Prior to my acceptance to the said college, I did not apply to any scholarship
grant or was not granted any scholarship from any institution or persons;

I have no existing scholarship grant;

I am executing this affidavit to attest to the truth of the foregoing statements

and whatever legal purposes this may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this
__th day of __________ 2021, at Dipolog City, Philippines.

NESTLE J. DITAY
(Affiant)
MSU Alumni ID#2015-0104-19
MSU-IIT Iligan City
With photo

SUBSCRIBED AND SWORN to before me this __th day of

_________ 2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JOSEPHINE S. ADRAINCEM, of legal age, Filipino, widow, a

resident of 593 C.P. Garcia Dt., Central Barangay, Dipolog City, after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:
 182. I am currently sixty(60) years old and employed by Department of
Education assigned at Zamboanga del Norte National High School, Dipolog
City;
183. The said age is a retirable age;
184. I am an applicant for loan before the Katipunan Bank, Dipolog City;
185. I utilize my employment as security on my said application for loan before
the said bank;
186. I hereby undertake that I will retire from my employment on the age of
sixty-five(65) years old;
187. In the event I will retire earlier than the said age, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
188. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

JOSEPHINE S. ADRAINCEM
(Affiant)
ZNNHS Employees ID#6366137-DEPED
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

I, ANITA SUMALPONG, of legal age, Filipino, single, resident of Punta, Dipolog City,
Zamboanga del Norte after having been duly sworn to an oath in accordance with law, do
hereby depose and say the following, THAT:

I am the transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot 2203-A-2-B-2,Psd-09-075187, situated at

Punta, Dipolog City, and covered by Transfer Certificate of Title No.
128-2016000558 issued by Register of Deeds for Dipolog City, containing
an area of two thousand one hundred fifty-five(2,155) square meters”.
The above stated parcel of land is agricultural land .
I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

ANITA SUMALPONG
(Affiant)
ID#_________________

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That, we:;AZUCENA M. CUENCA , of legal age, Filipino, married to Rodulfo R.

Cuenca, resident of Punta, Dipolog City, Zamboanga del Norte;EVELYN M.
SUAN, of legal age, Filipino, married to Exuferancio M. Suan, resident of Punta,
Dipolog City, Zamboanga del Norte;WINIFREDA M. JAOJAO, of legal age,
Filipino, married to Feliciano A. Jaojao, resident of Punta, Dipolog City,
Zamboanga del Norte;JOSE T. MINERALES, of legal age, Filipino, married to
Mercedita Lapa, resident of Seres, Katipunan, Zamboanga del Norte; after
having been duly sworn to an oath in accordance with law, do hereby depose and say the
following, THAT:

We are the transferees of parcels of land more particularly

described as follows:

1. “A parcel of land, situated at Seres, Katipunan, Zamboanga del Norte,

and covered by Transfer Certificate of Title No. T-581, containing an area
of (150)square meters issued by ROD for Zamboanga del Norte”

2. “A parcel of land, situated at Seres, Katipunan, Zamboanga del Norte,

and covered by Transfer Certificate of Title No. T-585, containing an area
of (224)square meters issued by ROD for Zamboanga del Norte”

3. “A parcel of land, situated at Seres, Katipunan, Zamboanga del Norte,

and covered by Transfer Certificate of Title No. T-586, containing an area
of (952)square meters issued by ROD for Zamboanga del Norte”

4. “A parcel of land known as Lot 1, Pcs-09-000629, situated at Basagan,

Katipunan, Zamboanga del Norte, and covered by Transfer Certificate of
Title No. T-70064, containing an area of (17,109)square meters issued by
ROD for Zamboanga del Norte”

5. “A parcel of land known situated at Seres, Katipunan, ZN covered by

Transfer Certificate of Title No.T-596 containing an area of 765 square
meters.”

The above stated parcels of land are agricultural land .

We, as transferee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application for
reclassification and plant them trees and agricultural products with introduction of
improvements without disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land.
In the event the said land be reclassified, we would submit all necessary requirements for
its reclassification.
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against us.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF we have hereunto affixed our signatures this ____ day
of _______ 2021, at Dipolog City.

JOSE T. MINERALES EVELYN M. SUAN

(Affiant) (Affiant and AIF of Azucena Cuenca)
VIN#7202-0289B-C1965JTM10000 OSCA ID#9874-Dipolog City

WINIFREDA M. JAOJAO
(Affiant)
UMID ID#CRN-0111-6395345-9

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

I, ANGELINA E. REDILLAS-CAIDET, of legal age, Filipino,widow, a resident of San

Antonio, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

I am one of the transferees of parcels of land more particularly described as

follows:

1.“A parcel of land known as Lot 323-C, covered by Transfer Certificate

of Title No.T-40641 situated at San Antonio, Polanco, Zamboanga del
Norte containing an area of 10,001 square meters.

2.“A parcel of land, covered by Transfer Certificate of Title No.T-2317

situated at Guinles, Polanco, Zamboanga del Norte containing an area of
6,271 square meters.

3. “A parcel of land known as Lot No.371-A, covered by Transfer

Certificate of Title No.T-67884 situated at Lingasaf, Polanco, Zamboanga
del Norte containing an area of 6,057 square meters.

4. “A parcel of land, covered by Tax Declaration No.14-0024-00361

situated at San Antonio, Polanco, Zamboanga del Norte containing an
area of 10,000 square meters.

The above stated parcels of land are agricultural lands.

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcels of land as agricultural land pending application for reclassification
and plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcels
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the lands or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.
ANGELINA REDILLAS-CAIDET
(Affiant)
OSCA ID#18-01591-Polanco,ZN

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

I, ANNA LYNN MANLUPIG, of legal age, Filipino, married to Chul Kee

Lee(Korean citizen), resident of Poblacion Alto, Sergio Osmena,
Zamboanga del Norte after having been duly sworn to an oath in accordance with
law, do hereby depose and say the following, THAT:

I am the transferee of parcel of land more particularly described as follows:

“A parcel of land known as Lot No.1787-N, CSD-09-

003080-D(Identical to Lot No.4489,Pls-5), situated at
Poblacion Alto, Sergio Osmeña, Zamboanga del Norte,
and covered by Original Certificate of Title No.P-33650,
containing an area of Sixteen thousand five hundred
eighty-nine(16,589) square meters”.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

ANNA LYN MANLUPIG

(Affiant)
ID#_________________

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ARTHUR RONALD B. PACULANANG, of legal age, Filipino,

married, a resident of 112 Turno, Dipolog City, after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

I am co-owner of a parcel of land, more particularly described as follows:

“ A Parcel of land known as Lot 5035 situated at Mandih, Sindangan, Zamboanga del
Norte covered by Transfer Certificate of Title No.T-72556 containing an area of 114,812
square meters”

I have applied for permit to cut before Philippine Coconut Authority for the coconut trees
situated at the said parcel of land;

The number of coconut trees to be cut are 600;

I hereby undertake to replace and replant the same number of 600 coconut trees as
replacement of the 600 trees to be cut;

I am executing this affidavit to attest to the truth of the foregoing statements and
whatever legal purposes this may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of
__________ 2021, at Dipolog City, Philippines.

ARTHUR RONALD B. PACULANANG

(Affiant)
Driver’s License#J01-85-000220
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JOSEPHINE S. ADRAINCEM, of legal age, Filipino, widow, a

resident of 593 C.P. Garcia Dt., Central Barangay, Dipolog City, after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

189. I am currently sixty(60) years old and employed by Department of

Education assigned at Zamboanga del Norte National High School, Dipolog
City;
190. The said age is a retirable age;
191. I am an applicant for loan before the Katipunan Bank, Dipolog City;
192. I utilize my employment as security on my said application for loan before
the said bank;
193. I hereby undertake that I will retire from my employment on the age of
sixty-five(65) years old;
 194. In the event I will retire earlier than the said age, I hereby authorize the
said bank to claim whatever balance of the obligation incurred from my
account;
195. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

JOSEPHINE S. ADRAINCEM
(Affiant)
ZNNHS Employees ID#6366137-DEPED
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

I, VEMA A. DAYUNOT, of legal age, Filipino,single, a resident of New Dapitan, Rizal,

Zamboanga del Norte A after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

I am the transferee of parcel of land more particularly described as follows:

 “A parcel of land known as Lot 3, covered by Transfer Certificate of Title
No.T-20697 situated at La Esperanza, Rizal, Zamboanga del Norte
containing an area of 19,262 square meters.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

VEMA A. DAYUNOT
(Affiant)
Postal ID#PRNM83180275622

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That, we: ROSALINA D. ANDO, of legal age, Filipino, married to Cirilo Ando, a
resident of De Venta Perla, Polanco, Zamboanga del Norte;BENIDO L.
DUHAYLUNGSOD, of legal age, Filipino, single, a resident of Sikitan, Piñan,
Zamboanga del Norte after having been duly sworn to an oath in accordance with law, do
hereby depose and say the following, THAT:

We are the owners of parcels of land more particularly described as follows:

1. A parcel of land known as Lot No. 1565-B covered by Transfer Certificate of

Title No. T-53718 situated at Sikitan, Piñan, Zamboanga del Norte,
containing an area of 22,554 square meters.
2. A parcel of land known as Lot 1585-D covered by Transfer Certificate of
Title No. T-51033 situated at Sikitan, Piñan, Zamboanga del Norte,
containing an area of 12,106 square meters.
The above stated parcel of land is agricultural land .
We, as parties, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land.
In the event the said land be reclassified, we would submit all necessary requirements for
its reclassification.
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF we have hereunto affixed our signatures this ____ day
of _______ 2021, at Dipolog City.

BENIDO L. DUHAYLUNGSOD ROSALINA D. ANDO

(Affiant) (Affiant)
AFP ID# R15-E-146983 OSCA ID#18-01835- Polanco, Zamboanga
del Norte

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARGETTE ADAZA NANOL , of legal age, Filipino, widow, a

resident of Orchid Villas Subd., Sta. Isabel, Dipolog City, after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:
 196. I am surviving spouse of EDGAR L. NANOL, School Principal III of
Department of Education, who died while in the government service.

197. I applied to claim the remaining claims, benefits, bonuses and all other
claims from the said agency of my late spouse.

198. I hereby authorized the agency to deduct all my late spouse’s financial
obligations from the said claims. If there is any final judgment on
disallowance against him, I am willing to refund all obligations due and
demandable.

199. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2021, at Dipolog City, Philippines.

MARGETTE ADAZA NANOL

(Affiant)
SSS ID#08-2113462-1
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2021, at

Dipolog City.

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That we:NARCISO O. BALAGOT, married to Elsa Catibig and LINA O. BALAGOT,

married to Jaime Neri, all of legal age, all Filipinos, all residents of Sergio Osmena,
Zamboanga del Norte after having been duly sworn to an oath in accordance with law, do
hereby depose and say the following, THAT:

We are the owners of parcel of land more particularly described as follows:

“A parcel of land covered by Katibayan ng Orihinal na Titulo Blg.P-

12520 situated at Labiray, Sergio Osmena, Zamboanga del Norte”.

The above stated parcel of land is agricultural land .

We, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land.
In the event the said land be reclassified, we would submit all necessary requirements for
its reclassification.
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF we have hereunto affixed our signatures this ____ day
of _______ 2021, at Dipolog City.

NARCISO O. BALAGOT
(Affiant)
OSCA ID#SO-14-105

LINA BALAGOT-NERI
(Affiant)
ID#___________
MAYBEL C. BUSTALIÑO

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JONATHAN N. BETANGCOR, of legal age, Filipino, single/married, a

resident of Relocation Site, Dicayas, Dipolog City, Zamboanga del Norte, after having
been duly sworn to an oath in accordance with law, do hereby depose and say:

That I am the representative of REAL MOTORS, owner of a motor vehicle more

particularly described as follows;

MAKE: HONDA Temporary Plate No.0901-0311801

Series: Wave

That,the said vehicle was allegedly involved in accident with another vehicle
described as Fuso Truck Fighter Dropside bearing Plate No. JDN 9798 on March 8, 2021
at around 8:40 in the evening, along National Highway, Galas, Dipolog City, Zamboanga
del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2021, at Dipolog City, Philippines.

JONATHAN N. BETANGCOR
(Affiant)
Non-Prof. DL#F01-18-005487

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2021, at

Dipolog City.
REPUBLIC OF THE PHILIPPINES}
PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That I, MAYBEL C. BUSTALIÑO, of legal age, Filipino, widow, resident of VCH,

Obay, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

I am the transferee/owner of parcel of land more particularly described as follows:

“A parcel of land known as Lot 875, Pls-5(HV 75037) situated at

Buenasuerte, Piñan(now Mutia), Zamboanga del Norte, and covered by
Original Certificate of Title No. P-3895 issued by Register of Deeds for
Zamboanga del Norte and Tax Declaration No.12-0003-00146, containing
an area of twenty nine thousand six hundred fifty-eight(29,658) square
meters”.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land.
In the event the said land be reclassified, I would submit all necessary requirements for
its reclassification.
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

MAYBEL C. BUSTALIÑO
(Affiant)
PRC ID#0012386-Agriculturist

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.
Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That I, DONNA PEARL A. VENTULA, of legal age, Filipino, single, resident of

Dansullan, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

I am the transferee/owner of portion of parcel of land more particularly described

as follows:
A parcel of land Lot No.5344-E, PSD-09-023429 situated at Dansullan,
Polanco, Zamboanga del Norte, and covered by Transfer Certificate of
Title No. T-53226, containing an area of 36,187 square meters issued by
Register of Deeds for Zamboanga del Norte
The above stated parcel of land is agricultural land .
I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

DONNA PEARL A. VENTULA

(Affiant)
ID#________________
 SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at
Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That I, DANAH A. MARAVILLAS rep by ARLENE A. MARAVILLAS, of legal age,

Filipino, married, resident of Dansullan, Polanco, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and say the following,
THAT:

I am the transferee/owner of portion of parcel of land more particularly described

as follows:
A parcel of land situated at Dansullan, Polanco, Zamboanga del Norte,
and covered by Original Certificate of Title No. P-12991, issued by
Register of Deeds for Zamboanga del Norte
The above stated parcel of land is agricultural land .
I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

DANAH A. MARAVILLAS rep. by:

ARLENE A. MARAVILLAS
(Affiant)

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

I, DONNA PEARL A. VENTULA, of legal age, Filipino, single, resident of

Dansullan, Polanco, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and say
the following, THAT:

I am the transferee/owner of portion of parcel of land more

particularly described as follows:
A parcel of land Lot No.5344-E, PSD-09-023429 situated at
Dansullan, Polanco, Zamboanga del Norte, and covered by
Transfer Certificate of Title No. T-53226, containing an area
of 36,187 square meters issued by Register of Deeds for
Zamboanga del Norte

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That I, DANAH A. MARAVILLAS rep by ARLENE A. MARAVILLAS, of legal age,

Filipino, married, resident of Dansullan, Polanco, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and say the following,
THAT:

I am the transferee/owner of portion of parcel of land more particularly described

as follows:
A parcel of land situated at Dansullan, Polanco, Zamboanga del Norte,
and covered by Original Certificate of Title No. P-12991, issued by
Register of Deeds for Zamboanga del Norte
The above stated parcel of land is agricultural land .
I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

DANAH A. MARAVILLAS rep. by:

ARLENE A. MARAVILLAS
(Affiant)

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RAENA GAY BALBUENA BULANDRES, of legal age, Filipino, single, a

resident of Poblacion, Siayan, Zamboanga del Norte after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

473. I am an applicant for a position Fire Officer 1, a member of the Bureau of

Fire Protection, at BFP Regional Office 9, Mayor Climaco Avenue, Zamboanga
City.
474. I could not submit the required authenticates documents for my
application on or before May 20, 2021 due to COVID-19 Pandemic. However, I
shall undertake to submit the required authenticated documents within reasonable
period of time as required by BFP, to wit:
-Professional Regulation Commission(PRC) ID
-Tax Identification Number(TIN) ID

475. Failure to submit the required documents shall be a ground for my

disqualification.
 476. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

RAENA GAY BALBUENA BULANDRES

(Affiant)
PRC ID#1780793 valid until 09/27/2022
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

REPUBILIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING

That we:FRANKLIN PALUCA, married to Marjorie Paluca; and EMERITO

PALUCA, married to Liza Paluca, all of legal age, all Filipinos, residents of
[Link], Dipolog City, Zamboanga del Norte , after having been duly
sworn to an oath in accordance with law, do hereby depose and say
the following, THAT:

We are the co-owners of parcels of land more particularly

described as follows:
“A parcel of land known Lot 3294-C, Psd-097202-019293, situated at
Bandera, Polanco, Zamboanga del Norte, and covered by Transfer
Certificate of Title No. T-63725, containing an area of (5,313) square
meters issued by ROD for Zamboanga del Norte”

The above stated parcel of land is agricultural land .

We, as vendees, hereby undertake to comply with requirements of rules and regulations
to use the said parcel of land as agricultural land pending application for reclassification
and plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF we have hereunto affixed our signatures this ____ day
of _______ 2021, at Dipolog City.

FRANKLIN PALUCA EMERITO PALUCA

(Affiant) (Affiant)
ID#_______________ ID#_________________

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

REPUBLIC OF THE PHILIPPINES}

PROVINCE OF ZAMBO. NORTE . . .} S.S.
CITY OF DIPOLOG . . . . . . . . . . . . . .}

AFFIDAVIT OF UNDERTAKING
That I, HANNAH LYN D. GUMAPON, of legal age, Filipino, single, a resident
of Brgy. [Link], Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say the following, THAT:

I am the buyer/owner of parcel of land more particularly described as

follows:

“A parcel of land Lot No. 1116-B of the subdivision plan, PSD-09-0444420,

situated at Brgy. of Nanginan, Municipality of Katipunan, Province of
Zamboanga del Norte, covered by Transfer Certificate of Title No. T-86525,
containing an area of nine thousand six hundred twelve(9,612) square meters”.

The above stated parcel of land is agricultural land .

I, as vendee, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, I would not reclassify the utilization/classification of the said parcel
of land
I fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
I am executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF I, have hereunto affixed my signature this ____ day of
_______ 2021, at Dipolog City.

HANNAH LYN D. GUMAPON

(Affiant)
TIN#312-946-898

SUBSCRIBED AND SWORN to before me this ___ day of _______ 2021, at

Dipolog City.

Doc. No.___
Page No.____
Book No.__
Series of 2021

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, PINKY O. MANCAO, of legal age, Filipino, single, a resident of Block 20 Lot

4, Victoria Country Homes, Obay, Polanco, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

477. I am an applicant for a position Fire Officer 1, a member of the Bureau of

Fire Protection, at BFP Regional Office 9, Mayor Climaco Avenue, Zamboanga
City.
478. I could not submit the required authenticates documents for my
application on or before May 3, 2021 due to COVID-19 Pandemic. However, I
shall undertake to submit the required authenticated documents within reasonable
period of time as required by BFP, to wit:
-Pag-ibig ID

479. Failure to submit the required documents shall be a ground for my

disqualification.
480. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of
___________2021, at Dipolog City, Philippines.

PINKY O. MANCAO
(Affiant)
Driver’s License #J01-20-010924
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MILA L. POWERS, of legal age, Filipino, married, resident of Galas,

Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say the following, THAT:

481. I am the buyer of parcel of land more particularly described as

follows:

“A parcel of land known as Lot No. 1052,GSS-09-000033(Phase II),

situated at Diwan, Dipolog City, and covered by Katibayan ng Orihinal
na Titulo Blg. P-1507 issued by Register of Deeds for Dipolog City,
containing an area of (19,197) square meters”.
482. The above stated parcel of land is agricultural land .
483. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
 for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
484. As of the mean, I would not reclassify the utilization/classification of the
said parcel of land
485. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
486. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MILA L. POWERS
(Affiant)
Driver’s License#J01-04-000394

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HERARD B. MANDANTES, of legal age, Filipino, married, a resident of

Banonong, Dapitan City, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle more particularly described as follows;

MAKE: KAWASAKI BODY TYPE: TC

ENGINE NO.DYYWJG82102 CHASSIS NO.:MD2A76BY3JWG69798
MV FILE#0901-00000425453 DENOMINATION:TRICYCLE
CR NO.35718334-1 SERIES:CT125A
 That,the said vehicle has franchise before the Dapitan City;

That however the registration of the said vehicle has already expired and not
renewed;

That there is intent to renew the registration of the said vehicle and its franchise;

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Dapitan City, Zamboanga del Norte;

That I undertake to renew the registration and franchise of the said motor vehicle;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2021, at Dipolog City, Philippines.

HERARD B. MANDANTES
(Affiant)
ID#________________________

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2021, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We:CHITO ELUMBARING, married; HONESTO ELUMBARING, married; ZITA E.

SIAO, married; CRESENCIO ELUMBARING; ALBINA Q. ELUMBARING, widow;all of
legal age, all Filipinos, and residents of Ilaya, Dapitan City, Zamboanga del Norte after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

We are the heirs of Cresencio Elumbaring who was the son of CERIACO
ELUMBARING,owner of a parcel of land known as:
Lot 4526 covered by Tax Declaration No.14-0027-00329 situated at [Link],
Polanco, Zamboanga del Norte under the name of Heirs of Jose Panopio

Ceriaco Elumbaring became the owner of the said parcel of land pursuant to Deed
of Sale executed by Felisa Calaguian and Cipriana Agacan;

Felisa Calaguian and Cipriana Agacan were the heirs of Jose Panopio;

We hereby undertake the truthfulness of the above statement and we attest that we
are the owners in concept of owners and possessor the of the said parcel of land;

In the event of legal complications, we hereby absolve the officers of Philippine

Coconut Authority from any liability and responsibility of the permit granted in relation
to this transaction;

We are executing this affidavit to attest to the truth of the foregoing statements
and whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2021, at Dipolog City, Philippines.

ALBINA Q. ELUMBARING HONESTO Q. ELUMBARING

(Affiant) (Affiant)
OSCA ID#005507 TIN#130-783-817

ZITA E. SIAO CRESENCIO

[Link],JR
(Affiant) (Affiant)
VIN#72010079AC16866210000-1
VIN#72010071AE0567CQE100000

CHITO Q. ELUMBARING
(Affiant)
ID#_______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARXON DAYMIEL CABRERA of legal age, Filipino, single, a resident of

683 Malvar [Link]. Estaka, Dipolog City, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

487. I am an applicant for a position of Fire Officer I, a member of the Bureau

of Fire Protection.
488. I am born January 26, 1993 in Dipolog City.
489. I am a graduate of Bachelor of Science in Industrial Technology at Negros
Oriental State University, Dumaguete City Campus in year 2019 and passed the
eligibility examinations for Career Service Professional of Civil Service
Commission.
490. I have not been dishonorably discharged from the Armed Forces of the
Philippines, BJMP, BFP or PNP or dismissed from the government service.
491. I have not been charged or convicted of any crime involving moral
turpitude.
492. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
493. I undertake to submit the required or lacking documents necessary for my
appointment once required by the Bureau of Fire Protection.
494. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
495. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
496. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Bureau of Fire Protection.

497. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MARXON D. CABRERA
(Affiant)
LTO ID#J01-11-003658

Valid until 2023/01/26

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARXON DAYMIEL CABRERA of legal age, Filipino, single, a resident of

683 Malvar [Link]. Estaka, Dipolog City, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

498. I am an applicant for a position of Fire Officer I, a member of the Bureau

of Fire Protection.
499. I am born January 26, 1993 in Dipolog City.
500. I am a graduate of Bachelor of Science in Industrial Technology at Negros
Oriental State University, Dumaguete City Campus in year 2019 and passed the
eligibility examinations for Career Service Professional of Civil Service
Commission.
501. I have not been dishonorably discharged from the Armed Forces of the
Philippines, BJMP, BFP or PNP or dismissed from the government service.
502. I have not been charged or convicted of any crime involving moral
turpitude.
503. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
504. I undertake to submit the required or lacking documents necessary for my
appointment once required by the Bureau of Fire Protection.
505. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
506. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
507. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Bureau of Fire Protection.

508. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MARXON D. CABRERA
(Affiant)
LTO ID#J01-11-003658

Valid until 2023/01/26

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That, we, ROSITA S. BINAG, of legal age, Filipino, widow, resident of San
Miguel, Polanco, Zamboanga del Norte;LORNA BINAG LUMANTAS, of legal age,
Filipino, married to Cipriano Lumantas, resident of San Miguel, Polanco, Zamboanga del
Norte; and, ROWENA BINAG CAINCAY, of legal age,Filipino, married to Joselito
Caincay, resident of San Miguel, Polanco, Zamboanga del Norte, , after having been duly
sworn to an oath in accordance with law, do hereby depose and say the following, THAT:

We are the co-owners of parcels of land more particularly described as follows:

1.“A parcel of land known Lot 9, Pcs-09-002565-AR/VLT, situated at San Miguel,

Polanco, Zamboanga del Norte, and covered by Transfer Certificate of Title No.
T-15750, containing an area of 4,093 square meters issued by ROD for
Zamboanga del Norte”
2.“A parcel of land known Lot 5567-A, PSD-09-034991-AR/VLT, situated at San
Miguel, Polanco, Zamboanga del Norte, and covered by Transfer Certificate of
Title No. T-15752, containing an area of 25,906 square meters issued by ROD for
Zamboanga del Norte”

The above stated parcel of land is agricultural land .

We, as owners, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2021, at Dipolog City, Philippines.

ROSITA S. BINAG LORNA B. LUMANTAS ROWENA [Link]

(Affiant) (Affiant) (Affiant)
OSCA ID#18-03615- SSS#10-02927915 VIN#7210081A1146RBC2000-3
PolancoZN
SUBSCRIBED AND SWORN to before me this __th day of ______ 2021, at
Dipolog City.

NILO R. CAIDET BENNY C. REPAJA

(Affiant) (Affiant)
VIN#7210007A1159NRC100006 VIN#72100079AE0763BCR200001

JOSE GERRY R. CAIDET ANGELINA R. CAIDET

(Affiant) (Affiant)
VIN#72100077AE1572JGC100003 OSCA ID#18-01591

PROTACIO R. CAIDET ANGELITA R. CAIDET MARLITO D. CAIDET

(Affiant) (Affiant) (Affiant)
DL#J01-01-035459 SSS#10-0555878-9 PNP#16J070284

LIMAR CAIDET ANN LIMARIE D. CAIDET ROY D. CAIDET

(Affiant) (Affiant) (Affiant)
DL#J01-12-003163 VIN#72100077AK0292 VIN#72100078BG1897
ADC1200008 RDC100005

LOVELY AN D. CAIDET JAY D. CAIDET

(Affiant) (Affiant)
School ID#15DF201525 School ID#639185

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, MERNALYN M. BINONDO, of legal age, Filipino, married, resident of
General Luna St. Central Barangay, Dipolog City, Zamboanga del Norte after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

509. I am a resident of Dipolog City with particularity of Gen. Luna St., Central
Barangay, Dipolog City;
510. I have been living in Dipolog City since 2009;
511. Although I have no house or real estate owned located in Dipolog City, I
have been living and residing the said address;
512. I have been registered as voter of the said barangay;
513. I have applied for Motorized Tricycle Operator’s Permit(MTOP) before
City Government of Dipolog City for my Trike with Temp. Plate No. 0901-09,
MV File No.0901-00000573444, Make/Type:Piaggio/Trike, CR No.38508370-5
514. In the event, I will transfer to another residence in the future, I hereby
undertake to relinquish my rights over the said MTOP to be issued under my
name effective my transfer of residence;
515. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MERNALYN M. BINONDO
(Affiant/AIF)
UMID ID#CRN-0111-4362211-1

SUBSCRIBED AND SWORN to before me this ___ day of _________

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, MARICEL RELUYA CAHILL, of legal age, Filipino, widow, resident of

Sangkol, Dipolog City, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

516. I am the owner of parcel of land known as “parcel of land known as

Lot No. 5738-D situated at Bandera, Polanco, Province of
Zamboanga del Norte, covered by Transfer Certificate of Title No.
T-85938, containing an area of 8,375 square meters”
517. The above stated parcel of land is agricultural land .
518. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
519. As of the mean, I would not reclassify the utilization/classification of the
said parcel of land
520. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
521. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MARICEL RELUYA CAHILL

Represented by:

MUHAREEM K. FRAYNA
(Affiant/AIF)
ID#_______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

That, we, NILO R. CAIDET, married to Jolyn Caidet; BENNY REPAJA,

married to Reynaldo Repaja; MARLITO D. CAIDET, single;LIMAR D. CAIDET,
married to Jane Caidet; ANNLIMARIE D. CAIDET, single; ROY D. CAIDET, single;
LOVELY AN D. CAIDET, single; JAY D. CAIDET, single; MAE ANN D. CAIDET,
single; PROTACIO CAIDET, married to Vilma Caidet; JOSE GERRY R. CAIDET,
single; ANGELINA E. REDILLAS CAIDET, widow; and ANGELITA R. CAIDET,
single; all of legal age, all Filipinos, and all residents of San Antonio, Polanco,
Zamboanga del Norte, after having been duly sworn to an oath in accordance with law,
do hereby depose and say the following, THAT:

We are the co-owners of parcel of land more particularly described as follows:

1.“A parcel of land known as Lot 323-C, Psd-09-009391 situated at San

Antonio, Polanco, Zamboanga del Norte with an area of 10,001 square
meters covered by Transfer Certificate of Title No. T-40641 issued by
Register of Deeds for Zamboanga del Norte ”
2“A parcel of land situated at Guinles, Polanco, Zamboanga del Norte
with an area of 6,271 square meters covered by Transfer Certificate of
Title No. T-2317 issued by Register of Deeds for Zamboanga del Norte ”
3. “A parcel of land known as Lot 371-A situated at Lingasad, Polanco,
Zamboanga del Norte with an area of 6,057 square meters covered by
Transfer Certificate of Title No. T-67884 issued by Register of Deeds for
Zamboanga del Norte ”
4.“A parcel of land known as Lot 342-B, situated at San Antonio,
Polanco, Zamboanga del Norte with an area of 10,000 square meters ”

The above stated parcel of land is agricultural land .

We, as owners, hereby undertake to comply with requirements of rules and regulations to
use the said parcel of land as agricultural land pending application for reclassification and
plant them trees and agricultural products with introduction of improvements without
disturbing the agricultural use and purpose of the parcels of land.
As of the meantime, we would not reclassify the utilization/classification of the said
parcel of land
We fully understand that any violation of the use of the land or any falsification or
misrepresentation of the information herein stated and in the documents we submitted
shall subject us to actions by filing of the appropriate civil, criminal and/or administrative
complaint against me.
We are executing this affidavit to attest to the truth of the foregoing statements and for
subdivision of said parcels of land and for titling and whatever legal purposes this may
serve.
IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2021, at Dipolog City, Philippines.

NILO R. CAIDET BENNY C. REPAJA

(Affiant) (Affiant)
VIN#7210007A1159NRC100006 VIN#72100079AE0763BCR200001

JOSE GERRY R. CAIDET ANGELINA R. CAIDET

(Affiant) (Affiant)
VIN#72100077AE1572JGC100003 OSCA ID#18-01591

PROTACIO R. CAIDET ANGELITA R. CAIDET MARLITO D. CAIDET

(Affiant) (Affiant) (Affiant)
DL#J01-01-035459 SSS#10-0555878-9 PNP#16J070284

LIMAR CAIDET ANN LIMARIE D. CAIDET ROY D. CAIDET

(Affiant) (Affiant) (Affiant)
DL#J01-12-003163 VIN#72100077AK0292 VIN#72100078BG1897
ADC1200008 RDC100005

LOVELY AN D. CAIDET JAY D. CAIDET

(Affiant) (Affiant)
School ID#15DF201525 School ID#639185

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MICHAEL ANGELO H. CHUA, of legal age, Filipino, married to Charisse A.

Chua, resident of Abapo Apartment, Herrera St., Dipolog, Zamboanga del Norte after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

522. I am the owner of portion of parcel of land known as “ A parcel of land

known as Lot No.2613-I-4, Psd-09-012590,situated at Sicayab,
Dipolog City, and covered by Transfer Certificate of Title No. T-
7270 issued by Register of Deeds for Dipolog City , containing an
area of 1,211.33 square meters”;
523. The above stated parcel of land is agricultural land .
524. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
525. As of the meantime, I would not reclassify the utilization/classification of
the said parcel of land.
526. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
 527. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MICHAEL ANGELO H. CHUA

(Affiant)
TIN#446-620-323

Marital Consent:

CHARISSE A. CHUA
TIN#273-978-299

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HAZEL A. LEOPOLDO, of legal age, Filipino, single, resident of Poblacion

South, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

528. I am the owner of portion of parcel of land known as “parcel of land

known as Lot No. 3358-B-3-A-2 situated at Bandera, Polanco,
Province of Zamboanga del Norte, covered by Transfer
Certificate of Title No. T-86592, containing an area of 2,847
square meters”
529. The above stated parcel of land is agricultural land .
530. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
 introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
531. As of the meantime, I would not reclassify the utilization/classification of
the said parcel of land.
532. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
533. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

HAZEL A. LEOPOLDO
(Affiant)
ID#_______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HAZEL A. LEOPOLDO, of legal age, Filipino, single, resident of Poblacion

South, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

534. I am the owner of portion of parcel of land known as “parcel of land

known as Lot No. 3358-B-3-A-2 situated at Bandera, Polanco,
Province of Zamboanga del Norte, covered by Transfer
Certificate of Title No. T-86592, containing an area of 2,847
square meters”
535. The above stated parcel of land is agricultural land .
536. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
 introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
537. As of the mean, I would not reclassify the utilization/classification of the
said parcel of land
538. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
539. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

HAZEL A. LEOPOLDO
(Affiant)
ID#_______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JARED S. CABALE, of legal age, Filipino, single, a resident of Conacon,

Poblacion North, Polanco, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the driver of a motor vehicle more particularly described as follows;

MAKE: SKYGO BODY:MOTORCYCLE

CR NO.37419104-2
 That,the said vehicle was allegedly involved in accident with another vehicle
described as Honda XRM 125 MC with Plate No. 6353 JI on February 3, 2021 at around
4:45 in the afternoon, along Dapdap, Poblacion South, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2021, at Dipolog City, Philippines.

JARED S. CABALE
(Affiant)
Alberto Ubay [Link]-Tech Science High School ID#LRN124295060023

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2021, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, Spouses FRANKLIN P. GUMAPON and CRISTINA D. GUMAPON, both

of legal age, both Filipinos, both residents of Poblacion South, Polanco, Zamboanga del
Norte after having been duly sworn to an oath in accordance with law, do hereby depose
and state, that:

540. We are the owners of parcel of land known as “parcel of land known
as Lot No. 1116-D, PSD-09-0444420 situated at Nanginan,
Katipunan, Province of Zamboanga del Norte, covered by
 Transfer Certificate of Title No. T-86527, containing an area of
9,611 square meters”
541. The above stated parcel of land is agricultural land .
542. We, as vendees, hereby undertake to comply with requirements of rules
and regulations to use the said parcel of land as agricultural land pending
application for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
543. As of the mean, we would not reclassify the utilization/classification of the
said parcel of land
544. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
545. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2021, at Dipolog City, Philippines.

FRANKLIN P. GUMAPON/CRISTINA D. GUMAPON

(Affiant)
ID#______________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, HANNAH LYN D. GUMAPON, of legal age, Filipino, single, resident of

Poblacion South, Polanco, Zamboanga del Norte after having been duly sworn to an oath
in accordance with law, do hereby depose and state, that:
 546. I am the owner of parcel of land known as “parcel of land known as
Lot No. 1116-B, PSD-09-0444420 situated at Nanginan,
Katipunan, Province of Zamboanga del Norte, covered by
Transfer Certificate of Title No. T-86525, containing an area of
9,612 square meters”
547. The above stated parcel of land is agricultural land .
548. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
549. As of the mean, I would not reclassify the utilization/classification of the
said parcel of land
550. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
551. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

HANNAH LYN D. GUMAPON

(Affiant)
TIN#312-946-898

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, EMMA ANGGIT-COLONNA, of legal age, Filipino, married, resident of
Bandera, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

552. I am the owner of a portion of parcel of land known as “parcel of land

known as Lot No. 3358-B-3-A-2, PSD-09-030006 situated at
Bandera, Polanco, Province of Zamboanga del Norte, covered by
Transfer Certificate of Title No. T-86592, containing an area of
2,847 square meters”
553. The above stated parcel of land is agricultural land .
554. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
555. As of the mean, I would not reclassify the utilization/classification of the
said parcel of land
556. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
557. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

EMMA ANGGIT-COLONNA
[Link]:

MARJORIE Q. PACATANG
(Affiant)
ID#________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

DOC. NO.______ IVO M. MANDANTES

PAGE NO.______ Notary Public
BOOK NO.______ Commission [Link]:ZDN-DPL-013-2020
SERIES OF 2021 Attorney’s Roll No. 65014
PTR No. 2185121-Dipolog City-1/4/2021
IBP No.122211-1/4/2021
Attorney’s Roll No. 65-14
MCLE [Link]-0000514,8-26-16 until 4/14/22
Lapu-lapu St., Dipolog City
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, JOCELYN B. ALONZO, of legal age, Filipino, married to Edgar Alonzo,

and resident of San Miguel, Polanco, Zamboanga del Norte;

EDDIE D. BELARMINO, of legal age, Filipino, married to Marilyn Cabalida, resident of

San Miguel, Polanco, Zamboanga del Norte represented by Jocelyn B. Alonzo;

MOISES D. BELARMINO, of legal age, Filipino, married to Lucia Arbule, resident of

San Miguel, Polanco, Zamboanga del Norte;

JULITO D. BELARMINO, of legal age, Filipino, married to Jessica Arong, resident of

San Miguel, Polanco, Zamboanga del Norte;

RELIX D. BELARMINO, of legal age, Filipino, single, resident of San Miguel, Polanco,
Zamboanga del Norte;

GEMMA DYWATCO, of legal age, Filipino, widow, resident of San Miguel,

Polanco,ZN, after having been duly sworn to an oath in accordance with law, do hereby
depose and say the following, THAT:

558. We are the transferees/owners of parcel of land more particularly

described as follows:
A parcel of land Lot No. 4, Pcs-09-079720-AR/VLT covered by Transfer Certificate of
Title No. T-15745 situated at San Miguel, Polanco, Zamboanga del Norte, containing an
area of Thirty Thousand(30,000) square meter
559. The above stated parcel of land is agricultural land .
560. We, as heirs, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
561. Once we will transform or change the usage of the land, we will submit
requirements necessary for reclassification.
562. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
563. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2021, at Dipolog City, Philippines.

JOCELYN B. ALONZO
(Affiant/ Attorney-in-fact of Eddie, Moises, Relix, Julito Belarmino and Gemma
Dywatco)
DL# J01-18-004221
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2021, at Dipolog
City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, , of legal age, Filipino, married, a resident of Block 13, Lot 17, VCH, Obay,
Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner of a motor vehicle more particularly described as follows;

MAKE: TOYOTA PLATE NO. NBY 8483

MODEL: WIGO CR NO. 283988725

That,the said vehicle was allegedly involved in accident with another vehicle
described as SKYGO 150 MC on December 1, 2020 at around 4:30 in the afternoon,
along National Highway, Obay, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

MARILISA E. MALAGUEÑO
(Affiant)
PRC ID#0354515 until 7/29/2022

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

We: JOCELYN B. ALONZO, of legal age, Filipino, married to Edgar

Alonzo, and resident of San Miguel, Polanco, Zamboanga del Norte;
EDDIE D. BELARMINO, of legal age, Filipino, married to Marilyn
Cabalida, resident of San Miguel, Polanco, Zamboanga del Norte
represented by Jocelyn B. Alonzo;

MOISES D. BELARMINO, of legal age, Filipino, married to Lucia Arbule,

resident of San Miguel, Polanco, Zamboanga del Norte;

JULITO D. BELARMINO, of legal age, Filipino, married to Jessica Arong,

resident of San Miguel, Polanco, Zamboanga del Norte;

RELIX D. BELARMINO, of legal age, Filipino, single, resident of San

Miguel, Polanco, Zamboanga del Norte after having been duly sworn to
an oath in accordance with law, do hereby depose and say the
following, THAT:

We are the transferees/owners of parcel of land more particularly

described as follows:
A parcel of land Lot No. 4, Pcs-09-079720-AR/VLT covered
by Transfer Certificate of Title No. T-15745 situated at San
Miguel, Polanco, Zamboanga del Norte, containing an area
of Thirty Thousand(30,000) square meters

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF RESIDENCY

I, LEONIE BAJAMUNDE, of legal age, Filipino, married to Angeles Tan,

resident of Egot, Estaka, Dipolog City, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

564. I am one of the owner of a portion of parcel of land known as “ A parcel of

land known as Lot 736 covered by Original Certificate of Title No.O-340, situated in
Egot, Estaka, Dipolog City issued by Register of Deeds for Dipolog City”.
565. I am a resident of Egot, Estaka, Dipolog City for being an heir of the
registered owner of the abovementioned parcel of land;
566. I had indicated my temporary residence at the time I executed the Deed of
Extra-judicial Partition with Simultaneous Sale before notary public which is
Cebu City;
567. But my true and permanent residence is Egot, Estaka, Dipolog City.
568. I hereby attest the truthfulness of the abovestatement.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.
 LEONIE BAJAMUNDE
(Affiant)
ID#_____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

DOC. NO.______ IVO M. MANDANTES

PAGE NO.______ Notary Public
BOOK NO.______ Commission [Link]:ZDN-DPL-013-2020
SERIES OF 2021 Attorney’s Roll No. 65014
PTR No. 2185121-Dipolog City-1/4/2021
IBP No.122211-1/4/2021
Attorney’s Roll No. 65-14
MCLE [Link]-0000514,8-26-16 until 4/14/22
Lapu-lapu St., Dipolog City

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF RESIDENCY

I, EMMA M. GALLENERO, of legal age, Filipino, married to Ildefonso

Sebastian, resident of Egot, Estaka, Dipolog City, Zamboanga del Norte after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

569. I am one of the owner of a portion of parcel of land known as “ A parcel of

land known as Lot 736 covered by Original Certificate of Title No.O-340, situated in
Egot, Estaka, Dipolog City issued by Register of Deeds for Dipolog City”.
570. I am a resident of Egot, Estaka, Dipolog City for being an heir of the
registered owner of the abovementioned parcel of land;
571. I had indicated my temporary residence at the time I executed the Deed of
Extra-judicial Partition with Simultaneous Sale before notary public which is
Zamboanga City;
572. But my true and permanent residence is Egot, Estaka, Dipolog City.
573. I hereby attest the truthfulness of the abovestatement.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.
 EMMA M. GALLENERO
(Affiant)
ID#_____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

DOC. NO.______ IVO M. MANDANTES

PAGE NO.______ Notary Public
BOOK NO.______ Commission [Link]:ZDN-DPL-013-2020
SERIES OF 2021 Attorney’s Roll No. 65014
PTR No. 2185121-Dipolog City-1/4/2021
IBP No.122211-1/4/2021
Attorney’s Roll No. 65-14
MCLE [Link]-0000514,8-26-16 until 4/14/22
Lapu-lapu St., Dipolog City

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF RESIDENCY

I, , NEMESIO M. GALLENERO, of legal age, Filipino, married to Nenita

Catalan, resident of Egot, Estaka, Dipolog City, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state, that:

574. I am the owner of a portion of parcel of land known as “ A parcel of land

known as Lot 736 covered by Original Certificate of Title No.O-340, situated in
Egot, Estaka, Dipolog City issued by Register of Deeds for Dipolog City”.
575. I am a resident of Egot, Estaka, Dipolog City for being an heir of the
registered owner of the abovementioned parcel of land;
576. I had indicated my temporary residence at the time I executed the Deed of
Extra-judicial Partition with Simultaneous Sale before notary public which is
Butuan City;
577. But my true and permanent residence is Egot, Estaka, Dipolog City.
578. I hereby attest the truthfulness of the abovestatement.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.
 NEMESIO M. GALLENERO
(Affiant)
ID#_____________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

DOC. NO.______ IVO M. MANDANTES

PAGE NO.______ Notary Public
BOOK NO.______ Commission [Link]:ZDN-DPL-013-2020
SERIES OF 2021 Attorney’s Roll No. 65014
PTR No. 2185121-Dipolog City-1/4/2021
IBP No.122211-1/4/2021
Attorney’s Roll No. 65-14
MCLE [Link]-0000514,8-26-16 until 4/14/22
Lapu-lapu St., Dipolog City

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, , MARILYN ZAMORAS, of legal age, Filipino, single, resident of Egot,

Estaka, Dipolog City, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

579. I am the owner of a portion of parcel of land known as “ A parcel of land

known as Lot 736 covered by Original Certificate of Title No.O-340, situated in
Egot, Estaka, Dipolog City issued by Register of Deeds for Dipolog City”.
580. The above stated parcel of land is agricultural land .
581. I, as vendee, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
582. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
 documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
583. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2021, at Dipolog City, Philippines.

MARILYN E. ZAMORAS
(Affiant)
Driver’s License#J01-93-016100

SUBSCRIBED AND SWORN to before me this ___ day of _________

2021, at Dipolog City.

DOC. NO.______ IVO M. MANDANTES

PAGE NO.______ Notary Public
BOOK NO.______ Commission [Link]:ZDN-DPL-013-2020
SERIES OF 2021 Attorney’s Roll No. 65014
PTR No. 2185121-Dipolog City-1/4/2021
IBP No.122211-1/4/2021
Attorney’s Roll No. 65-14
MCLE [Link]-0000514,8-26-16 until 4/14/22
Lapu-lapu St., Dipolog City

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, Heirs of Saturnino B. Jumawan represented by Syn S.

Jumawan, Iris Cyd J. Suarez, Jurby S. Jumawan and Adriel S. Jumawan
, of legal age, Filipino, all married except Adriel Jumawan, all
residents of Poblacion South, Polanco, Zamboanga del Norte Eva J.
Calasang, of legal age, Filipino, married to Cerilo Calasang, a resident
of Poblacion South, Polanco, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

584. We are the owners of a portion of parcel of land known as “A parcel of

land known as Lot 3303-B covered by TCT No.T-14804 situated
at Poblacion South, Polanco, Zamboanga del Norte, containing
an area of 7,827 square meters”.
585. The above stated parcel of land is agricultural land .
586. We, as heirs, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
 for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in
the documents we submitted shall subject us to actions by filing of the
appropriate civil, criminal and/or administrative complaint against me.
587. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2020, at Dipolog City, Philippines.

Syn S. Jumawan Iris Cyd J. Suarez Jurby S. Jumawan

Adriel S. Jumawan
(Heir) (Heir) (Heir)
(Heir)
Passport#XX5278492 DL#J01-11-003492 Passport#XX2795272

DL#J01-11-
003493

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, Alex B. Jumawan, of legal age, Filipino, single, a resident of
Poblacion South, Polanco, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

588. I am the owner of a portion of parcel of land known as “A parcel of

land known as Lot 3303-B covered by TCT No.T-14804 situated
at Poblacion South, Polanco, Zamboanga del Norte, containing
an area of 7,827 square meters”.
589. The above stated parcel of land is agricultural land .
590. I, as heir, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
591. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
592. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ALEX B. JUMAWAN
(Affiant)
OSCA ID#18-03949-Polanco,ZN

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, Clarita J. Candelaria, of legal age, Filipino, widow, a resident

of Poblacion South, Polanco, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

593. I am the owner of a portion of parcel of land known as “A parcel of

land known as Lot 3303-B covered by TCT No.T-14804 situated
at Poblacion South, Polanco, Zamboanga del Norte, containing
an area of 7,827 square meters”.
594. The above stated parcel of land is agricultural land .
595. I, as heir, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
596. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
597. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

CLARITA J. CANDELARIA
(Affiant)
SSS#33-9600689-6

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, Lorna J. Sestoso, of legal age, Filipino, married to Roger

Sestoso, a resident of Poblacion South, Polanco, Zamboanga del Norte
after having been duly sworn to an oath in accordance with law, do hereby depose and
state, that:

598. I am the owner of a portion of parcel of land known as “A parcel of

land known as Lot 3303-B covered by TCT No.T-14804 situated
at Poblacion South, Polanco, Zamboanga del Norte, containing
an area of 7,827 square meters”.
599. The above stated parcel of land is agricultural land .
600. I, as heir, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
601. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
602. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

LORNA J. SESTOSO
(Affiant)
VIN#2250-0004B-F2562LJS200000

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, Virginia Jumawan, of legal age, Filipino, widow of Santiago

Jumawan,Jr., a resident of Poblacion South, Polanco, Zamboanga del
Norte after having been duly sworn to an oath in accordance with law, do hereby
depose and state, that:

603. I am the representative of owner of a portion of parcel of land known as

“A parcel of land known as Lot 3303-B covered by TCT No.T-
14804 situated at Poblacion South, Polanco, Zamboanga del
Norte, containing an area of 7,827 square meters”.
604. The above stated parcel of land is agricultural land .
605. I, as heir, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
606. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
607. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

VIRGINIA JUMAWAN
(Affiant)
ID#_______________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.
]

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ABNER L. CLAUNAN, of legal age, Filipino, married, a resident of Labiray,

Sergio Osmena, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the President of OFW SIBULAN ASSOCIATION, with business

address of Sergio Osmena, Zamboanga del Norte;

That the association is the proponent of OFW GRACER BIGASAN STORE to be

situated at Biayon, Sergio Osmena;

That the said proposed business is to be managed and manned by the members of
the association;

That the target market of the association are also the members and the residents of
the Sergio Osmena by buying rice/corn and reselling it for profit;

That there is high demand of rice and corn in the area due to the increase of
consuming population but there is no increase in the area of supply chain;

That the association will undertake to further endeavor and achieve growth in the
sales of the OFW GRACER BIGASAN STORE within a year from its conception.

That I attest to the truthfulness of the above statement.

.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

ABNER L. CLAUNAN
(Affiant)
President, OFW SIBULAN ASSOCIATION
UMID#CRN-0111-5966297-4

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARILISA E. MALAGUEÑO, of legal age, Filipino, married, a resident of

Block 13, Lot 17, VCH, Obay, Polanco, Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the owner of a motor vehicle more particularly described as follows;

MAKE: TOYOTA PLATE NO. NBY 8483

MODEL: WIGO CR NO. 283988725

That,the said vehicle was allegedly involved in accident with another vehicle
described as SKYGO 150 MC on December 1, 2020 at around 4:30 in the afternoon,
along National Highway, Obay, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

MARILISA E. MALAGUEÑO
(Affiant)
PRC ID#0354515 until 7/29/2022

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.
Doc No. _____ IVO M. MANDANTES,CPA
Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RODENER D. JUMARAN, married, of legal age, Filipino, and resident of

Estaka St., Estaka, Dipolog City after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

608. I am the attorney-in-fact of buyer of parcel of land known as “A parcel of

land known as Lot No. 3042-A, situated at Tubod, Galas, Dipolog City, and
covered by Transfer Certificate of Title No. T-24522 issued by Register of Deeds
for Dipolog City, containing an area of 230 square meters”.
609. The above stated parcel of land is agricultural land
610. The area purchased/inherited classified as agricultural land, I warrant as
attorney-in-fact not to change the actual use of the property from agricultural land
use to some other uses or purposes;
611. In the future, the buyer will decide to change its use from agricultural to
residential, commercial or industrial, I undertake to comply documentary
requirements for Land Use Conversion Order, the application of which , to be
filed before the DAR, Regional Office, Zamboanga City/DAR, Central Office,
Quezon City
612. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents I submitted shall subject us to actions by filing of the appropriate civil,
criminal and/or administrative complaint against me.
613. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

RODENER D. JUMARAN
Attorney-in-Fact of Froilan Serohijos &Alma Derama Serohijos
 (Affiant)
Driver’s License#J01-06-002874

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, [Link] G. CANINIT, of legal age, Filipino, single, a resident of

Linabo, Polanco, Zamboanga del Norte;
[Link] G. DALONG, of legal age, Filipino, married to Feliciano Dalong, a resident
of Linabo, Polanco, Zamboanga del Norte;
3. IRINE G. MONTIFALCON, of legal age, Filipino, married to Allan Montifalcon, a
resident of Linabo, Polanco, Zamboanga del Norte;
4. EMILY G. ALMACIN, of legal age, Filipino, married to Julieto G. Almacin, a
resident of Linabo, Polanco, Zamboanga del Norte;
[Link] G. BUGAY, of legal age, Filipino, married to Allan Bugay, a resident of
Linabo, Polanco, Zamboanga del Norte;
[Link] A. GUMAPIT, of legal age, Filipino, single, a resident of Linabo, Polanco,
Zamboanga del Norte;
7. FORTUNATE A. GUMAPIT, of legal age, Filipino, single, a resident of Linabo,
Polanco, Zamboanga del Norte;
8. JANETTE A. GUMAPIT, of legal age, Filipino, single, a resident of Linabo, Polanco,
Zamboanga del Norte after having been duly sworn to an oath in accordance with law, do
hereby depose and state, that:
614. we are the transferees of a portion of parcel of land known as A parcel of
land known as Plan F-09-01-19139-D covered by Original Certificate of Title No.
P-28756 situated at Linabo, Polanco, Zamboanga del Norte, containing an area of
(49,998) square meters:

615. The above stated parcel of land is agricultural land .

 616. we, as transferees, hereby undertake to comply with requirements of rules
and regulations to use the said parcel of land as agricultural land pending
application for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
617. we fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
618. we are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.
IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2020, at Dipolog City, Philippines.

ROSEMARIE G. CANINIT RACILL G. DALONG IRINE G. MONTIFALCON

(Affiant) (Affiant) (Affiant)
VIN#831200033bG0172RAG20 UMID#CRN-0111-39920636 Postal#PRNM8316058
0001

EMILY G. ALMACIN ELSA G. BUGAY ELENA A. GUMAPIT

(Affiant) (Affiant) (Affiant)
TIN#469-008-543 Postal ID#1414771 TIN#436039834

ARLYN A. GUMAPIT FORTUNATE A. GUMAPIT JANETTE A. GUMAPIT

(Affiant) (Affiant) (Affiant)
UMID#CRN011113478531 DL#J01-15-001820 UMID#CRN001007778525
SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ALFREDO A. TOROT, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

619. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
 del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
620. The above stated parcel of land is agricultural land .
621. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
622. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
623. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ALFREDO A. TOROT
(Affiant)
TIN#946609639

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LEONARDO A. CERIALES, Filipino, of legal age, Filipino, single, a resident

of East Poblacion, Manukan, Zamboanga del Norte, Philippines, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:
 That I am the common law husbanf of deceased MYRNA VELASCO
MONARES, a domestic helper in Peoples Republic of China;

That I hereby give consent to the cremation of the remains of MYRNA

VELASCO MONARES in the abovesaid country and the transport of her ashes to the
Philippines;

That I hereby affirm that I have no claim against the Department of Foreign
Affairs(DFA) or any of its officers and employees. In the event that another claimant
surfaces, I shall keep free from harm and claim the DFA will be subject of and defend the
latter against any proceedings;

That I execute this affidavit of undertaking to attest the aforementioned

statements and be bound to all legal aspects under the laws of the Philippines
.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

LEONARDO A. CERIALES
(Affiant)
Driver’s License#J01-17-001715

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, FELLY ROSE GEGRIMOSA, of legal age, Filipino, single, a resident of

Bypass, Turno, Dipolog City, after having been duly sworn to an oath in accordance with
law, do hereby depose and say:

That I am the owner of a motor vehicle more particularly described as follows;

Yamaha Mio 125 bearing termporary plate no. 0901-0361753 with Engine No. E3R2E-
1989002, Chassis No. PA0SE9810J0273101.

That,the said vehicle was allegedly involved in accident with another vehicle
described as Honda Wave bearing Plate No. 8748JH on October 17, 2020 along Bypass
Road, Turno, Dipolog City.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

FELLY ROSE GEGRIMOSA

(Affiant)
ID#____________________

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NILO [Link], of legal age, Filipino, married, a resident of Isis, Polanco,

Zamboanga del Norte, after having been duly sworn to an oath in accordance with law,
do hereby depose and say:

That I am the driver of owner of vehicle described below;

Toyota L Passenger type with Plate [Link] 738

That,the said vehicle was allegedly involved in accident with another vehicle
described as Honda City 2018 bearing plate No. E0G 323 on September 30, 2020 along
[Link] and Jose [Link] St, [Link], Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;

That I hereby request for the release of the said motor vehicle registered to the
name of Expedito Beldad with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation involving it
anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

NILO P. AVES
(Affiant)
DL#J01-89-009774

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NEILGYM M. BECADA, of legal age, Filipino, single, a resident of

Langatian, Roxas, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

624. I am the owner of a portion of parcel of land known as “A parcel of land

known as Lot 533-M, CSD-09-001697-D, situated at New Tambo, Katipunan,
Zamboanga del Norte, and covered by Transfer Certificate of Title No. 127-
2017000435 issued by Register of Deeds for Zamboanga del Norte, containing an
area of four thousand four hundred thirty-nine(4,439) square meters ”.
625. The above stated parcel of land is agricultural land .
626. I, as OWNER, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
627. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
628. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

NEILGYM M. BECADA
(Affiant)
Driver’s License#J01-06-001180

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.
Doc No. _____ IVO M. MANDANTES,CPA
Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ROBERTO T. PATCHO, of legal age, Filipino, widower, and resident of

Binalabag,Olingan, Dipolog City, Zamboanga del Norte after having been duly sworn to
an oath in accordance with law, do hereby depose and state, that:

629. I am the widower of HERLICA [Link]-PATCHO who was a

Teacher I of Department of Education.
630. My said spouse died on May 6, 2020 at Dipolog City .
631. My late spouse obligations from the agency and banks were fully paid and
settled;
632. In the event there are still obligations due and yet to be settled the
undersigned undertakes to settle and allow the Department of Education to deduct
the obligations due from the remaining claims and last payment of my spouse.
633. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ROBERTO T. PATCHO
(Affiant)
Driver’s License#J01-13-003346

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
 IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ALFREDO A. TOROT, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

634. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
635. The above stated parcel of land is agricultural land .
636. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
637. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
638. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ALFREDO A. TOROT
(Affiant)
TIN#946609639

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.
Doc No. _____ IVO M. MANDANTES,CPA
Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ERNESTO S. MALANGOT, of legal age, Filipino, married and resident of

Sinuyak, Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

639. I am the owner of a portion of parcel of land known as “A parcel of land

known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga del
Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
640. The above stated parcel of land is agricultural land .
641. I, as OWNER, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
642. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
643. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ERNESTO S. MALANGOT
(Affiant)
DL#N03-95-185247
SUBSCRIBED AND SWORN to before me this ___ day of _________
2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, EDELITO S. MALANGOT, of legal age, Filipino, married and resident of

Sinuyak, Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

644. I am the owner of a portion of parcel of land known as “A parcel of land

known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga del
Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
645. The above stated parcel of land is agricultural land .
646. I, as OWNER, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
647. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
648. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

EDELITO S. MALANGOT
(Affiant)
DL#N02-91-174301
SUBSCRIBED AND SWORN to before me this ___ day of _________
2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, EDGAR S. MALANGOT, of legal age, Filipino, married to Christopher Catape

and resident of Sinuyak, Katipunan, Zamboanga del Norte after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

649. I am the owner of a portion of parcel of land known as “A parcel of land

known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga del
Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
650. The above stated parcel of land is agricultural land .
651. I, as OWNER, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
652. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
653. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

EDGAR S. MALANGOT
(Affiant)
 DL#N2599067213

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ELENITA M. CATAPE, of legal age, Filipino, married to Christopher Catape

and resident of Sinuyak, Katipunan, Zamboanga del Norte after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

654. I am the owner of a portion of parcel of land known as “A parcel of land

known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga del
Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
655. The above stated parcel of land is agricultural land .
656. I, as OWNER, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
657. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
658. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ELENITA M. CATAPE
 (Affiant)
UMID#CRN-0033-2306789-5

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARIVIC B. LAGORRA, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

659. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
660. The above stated parcel of land is agricultural land .
661. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
662. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
663. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of
___________2020, at Dipolog City, Philippines.

MARIVIC B. LAGORRA
(Affiant)
TIN#400625563

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ELZIE B. GAHUM, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

664. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
665. The above stated parcel of land is agricultural land .
666. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
667. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
 668. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ELZIE B. GAHUM
(Affiant)
TIN#938752155

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, BERNARDITA B. ORILLAN, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

669. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
670. The above stated parcel of land is agricultural land .
671. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
 672. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
673. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

BERNARDITA B. ORILLAN
(Affiant)
PPP#097203022021100197

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ROGELIO C. SANTIAGO, married, of legal age, Filipino, and resident of

Sinuyak,Katipunan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

674. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land known as Lot No. 2982-G-2-A, situated at Sinuyak, Katipunan, Zamboanga
del Norte, and covered by Transfer Certificate of Title No. T-43518 issued by
Register of Deeds for Zamboanga del Norte, containing an area of 23,122 square
meters”.
675. The above stated parcel of land is agricultural land .
676. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
 introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
677. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
678. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ROGELIO C. SANTIAGO
(Affiant)
UMID#CRN-006-0088-5776-7

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, REY C. CORDOVA, of legal age, Filipino, married, a resident of Dipolog City,

after having been duly sworn to an oath in accordance with law, do hereby depose and
say:

That I am the Credit and Collection Supervisor of SMCT-Des Appliance Plaza,

Inc.-Quezon-Dipolog Branch. That the vehicle described below is mortgaged to our
company;
Suzuki MC Raider J Pro color Black with Engine No. E469-151506,Chassis
No.BE4EB-301422.
 That,the said vehicle was allegedly involved in accident with another vehicle
described as Toyota Hi-ace Grandia color pearl white with Plate No.A7 J959 on October
28, 2019 along National Highway, Sicayab, Dipolog City.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte; That thereafter the
owner of the vehicle is not interested anymore to recover the vehicle from the said office;

That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

REY C. CORDOVA
(Affiant)
SMCT ID#115-021808

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ROGELIO DINAGUET, of legal age, Filipino, a resident of Sta. Filomena,

Dipolog City represented by DANILO SUMILANG after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

679. I am the owner/buyer of a portion of parcel of land known as “A parcel

of land known as Lot No. 4642-C, Psd-69542, situated at Loboc,
Polanco(then Dipolog), Zamboanga del Norte, and covered by
Transfer Certificate of Title No. T-21487 issued by Register of
 Deeds for Zamboanga del Norte, containing an area of 15,882
square meters”.
680. The above stated parcel of land is agricultural land .
681. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
682. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
683. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ROGELIO DINAGUET
(Affiant)
Represented by:

DANILO SUMILANG
ID#___________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, JOHNN WAYNNE P. ANTIQUINA of legal age, Filipino, single, a resident of
Poblacion, Sibutad, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

684. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
685. I am born July 23, 1997 in Manila.
686. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examinations for Criminology students in November 29-December 1,
2019.
687. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
688. I have not been charged or convicted of any crime involving moral
turpitude.
689. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
690. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
691. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
692. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

693. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

JOHNN WAYNNE P. ANTIQUINA

(Affiant)
PRC ID#0197641-Criminologist
Valid until 7/23/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, MARIA MAY D. PAEL of legal age, Filipino, single, a resident of East
Poblacion, Manukan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

694. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
695. I am born May 15, 1997 at East Poblacion, Manukan, Zamboanga del
Norte.
696. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examinations for Criminology students in November 29-December 1,
2019.
697. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
698. I have not been charged or convicted of any crime involving moral
turpitude.
699. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
700. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
701. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
702. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

703. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

MARIA MAY D. PAEL

(Affiant)
Philhealth ID#14-251908901-6

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, REGIE B. ESTERA of legal age, Filipino, single, a resident of Bayang,
Gulayon, Dipolog City, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

704. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
705. I am born September 19, 1997 in Manila.
706. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examinations for Criminology students in November 29-December 1,
2019.
707. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
708. I have not been charged or convicted of any crime involving moral
turpitude.
709. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
710. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
711. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
712. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

713. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

REGIE B. ESTERA
(Affiant)
PRC ID#0210503-Criminologist
Valid until 9/19/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, BELYNDA RIO MALUMBRES, of legal age, Filipino, single, a resident of
Milad, Polanco, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

714. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
715. I am born March 28, 1994 at Milad, Polanco, Zamboanga del Norte.
716. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examinations for Criminology students in November 29-December 1,
2019.
717. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
718. I have not been charged or convicted of any crime involving moral
turpitude.
719. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
720. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
721. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
722. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

723. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

BELYNDA RIO MALUMBRES

(Affiant)
PRC ID#0208310-Criminologist
Valid until 3/28/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, FRANCIS JEFF P. CORONEL, of legal age, Filipino, single, a resident of Sto.
Niño Village, Minaog, Dipolog City, Zamboanga del Norte after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

724. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
725. I am born June 17, 1998 at Minaog, Dipolog City.
726. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examinations for Criminology students in November 29-December 1,
2019.
727. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
728. I have not been charged or convicted of any crime involving moral
turpitude.
729. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
730. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
731. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
732. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

733. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

FRANCIS JEFF P. CORONEL

(Affiant)
PRC ID#0206980-Criminologist
Valid until 6/17/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, JULIETO L. EBONDAS, married to Aida Ebondas, of legal age, Filipino, and
resident of Segabe, Pinan, Zamboanga del, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

734. I am the transferee of a portion(130 sqm) of parcel of land known as”A

parcel of land Lot 4,, Pcs-09-002693, situated at Poblacion Alto, Sergio Osmeña,
Zamboanga del Norte, covered by Transfer Certificate of Title No. T-64474
issued by Register of Deeds for Zamboanga del Norte, containing an area of
(10,964) square meters”.

735. The above stated parcel of land is agricultural land .

736. I, as transferee, hereby undertake to comply with requirements of rules

and regulations to use the said parcel of land as agricultural land pending
application for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.

737. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
738. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

JULIETO L. EBONDAS
(Affiant)
ID#_________________

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, , FELICISIMO C. ALAMPANGAN, married to Aida Alampangan; LORNA

C. BASILIO, married to Flordelito Basilio; and DOLORES CAMPOS, single, all of legal
age, all Filipinos, and residents of Labrador, Polanco, Zamboanga del Norte after having
been duly sworn to an oath in accordance with law, do hereby depose and state, that:

739. we are the transferees of a portion of parcel of land known as “A parcel of

land Lot No. 121, Gss-142, situated at Lapayanbaja, Polanco, Zamboanga del
Norte, covered by Original Certificate of Title No. P-10688, containing an area of
(14,304) square meters.:

740. The above stated parcel of land is agricultural land .

741. we, as transferees, hereby undertake to comply with requirements of rules
and regulations to use the said parcel of land as agricultural land pending
application for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
742. we fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
743. we are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2020, at Dipolog City, Philippines.

FELICISIMO C. ALAMPANGAN
(Affiant)
DL#J01-00-032746

LORNA C. BASILIO DOLORES CAMPOS

(Affiant) (Affiant)
TIN#13908930414 TIN#932765435

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, Spouses Edgar O. Alvaro and Cecilia Alvaro, both of legal age, Filipinos, a
resident of Dansullan, Polanco, Zamboanga del Norte after having been duly sworn to an
oath in accordance with law, do hereby depose and state, that:

744. we are the owner/buyers of a portion of parcel of land known as “A parcel

of land Lot No.5350-B-5, situated at Dansullan, Polanco, Zamboanga del Norte,
covered by Transfer Certificate of Title No. T-53298, containing an area of 6,232
square meters”.
745. The above stated parcel of land is agricultural land .
746. we, as buyers, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
747. we fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
748. we are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of ___________2020, at Dipolog City, Philippines.

EDGAR O. ALVARO/CECILIA ALVARO

(Affiant)
ID#___________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT

I, CHARMAE B. UY, of legal age, Filipino, married, a resident of

#88 corner One Heart Subdivision Sta. Isabel, Dipolog City, after having
been duly sworn to an oath in accordance with law, do hereby depose and
say:

That I am the proprietor/owner/franchisee of JULIE’S BAKESHOP-

Turno, Dipolog City Branch, located at Highway Turno, Dipolog City

That the said parcel of land and commercial building being used and
operated by Julie’s Bakeshop-Turno, Dipolog City Branch is not owned by
the undersigned but it is under contract of lease with the undersigned affiant
as Lessee;

That I am executing this affidavit in good faith to attest to the above

statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_____ day of _____ 2020, at Dipolog City, Philippines.

CHARMAE B. UY
(Affiant)
ID#___________________________________

SUBSCRIBED AND SWORN to before me this ___ day of ____

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
 ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NOEL A. PATANGAN, of legal age, Filipino, married, a resident of Purok

Manga, Silawe, Polanco, Zamboanga del Norte, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the authorized driver and owner of the motor vehicle involved in a
vehicular accident on February 19, 2020 at around or about 8:30 am, along National
Highway, New Lebangon, Polanco, Zamboanga del Norte, described as follows:

White Honda XRM 125 MC with Plate No. JA 81670;

That,the said vehicle was allegedly involved in accident with another vehicle
described as Mazda Bongo bearing Plate No. JDO 3106, White Izusu Canter bearing
Plate No. AFA 3414 and Toyota Vios bearing conduction sticker P5K492.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
 That I hereby request for the release of the said motor vehicle registered to my
name with the undertaking that I shall make the same available to the Honorable
Prosecutor or any authority in connection with any investigation involving it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2020, at Dipolog City, Philippines.

NOEL A. PATANGAN,SR.
(Affiant)
Driver’s License#J01-15-003802

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JOHN KEVIN BRYAN MALINAO BARIMBAO, of legal age, Filipino,

single, a resident of Brgy. Dapaon, Sindangan, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state, that:

749. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
750. I am born January 6, 1992 at Baesa Mendez, Quezon City.
751. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2018 and passed the
eligibility examininations for Criminology students in November 2019.
 752. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
753. I have not been charged or convicted of any crime involving moral
turpitude.
754. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
755. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
756. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
757. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

758. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

JOHN KEVIN BRYAN MALINAO BARIMBAO

(Affiant)
Driver’s License#L05-18-006634
Valid until 1/06/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NOE SAGARIO NAPUECAS, of legal age, Filipino, single, a resident of

Socon, Masidlakon, Dapitan City, Zamboanga del Norte after having been duly sworn to
an oath in accordance with law, do hereby depose and state, that:

759. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
760. I am born October 21, 1998 at Dapitan City.
 761. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examininations for Criminology students in November 2019.
762. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
763. I have not been charged or convicted of any crime involving moral
turpitude.
764. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
765. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
766. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
767. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

768. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

NOE SAGARIO NAPUECAS

(Affiant)
Driver’s License#J01-19-002205
Valid until 10/21/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, RODIENER MURRO TOMAS, of legal age, Filipino, single, a resident of

Binuangan, Sindangan, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

769. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
 770. I am born August 2, 1996 at Binuangan, Sindangan, Zamboanga del Norte
.
771. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examininations for Criminology students in November 2019.
772. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
773. I have not been charged or convicted of any crime involving moral
turpitude.
774. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
775. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
776. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
777. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

778. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

RODIENER MURRO TOMAS

(Affiant)
Driver’s License#J07-18-001211
Valid until 8/2/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JOHN KEVIN BRYAN MALINAO BARIMBAO, of legal age, Filipino,

single, a resident of Brgy. Dapaon, Sindangan, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state, that:
 779. I am an applicant for a position Patrolman, a member of the Philippine
National Police.
780. I am born January 6, 1992 at Baesa Mendez, Quezon City.
781. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2018 and passed the
eligibility examininations for Criminology students in November 2019.
782. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
783. I have not been charged or convicted of any crime involving moral
turpitude.
784. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
785. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
786. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
787. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

788. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

JOHN KEVIN BRYAN MALINAO BARIMBAO

(Affiant)
Driver’s License#L05-18-006634
Valid until 1/06/2023

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, IRA RUTH J. LAKIAN-LISONDRA, of legal age, Filipino, married, a resident of

Madison County, Dicayas, Dipolog City , after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

789. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City. I effectively signed on September 2018.
790. I applied to claim my terminal leave benefits and all other claims from the
hospital;
791. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demandable.
792. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2020, at Dipolog City, Philippines.

IRA RUTH J. LAKIAN-LISONDRA

(Affiant)
PRC ID#0446711
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN, CITIES OF DIPOLOG/DAPITAN
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020-Dipolog City
IBP NO.095495,11/22/2019 for CY2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. ESTAKA,DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, GIOVANNI LABADAN GULFERE, of legal age, Filipino, single, a resident of

Gulayon, Dipolog City, Zamboanga del Norte after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

793. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
794. I am born on October 24, 1997 at Dipolog City.
795. I passed the Licensure Examinations for Criminologist using the name
Giovanni Labadan Gulfere;
796. Upon securing my PSA Certified Certificate of Live Birth, I found out that
my name is still Giovanni Redillas Labadan. My last name Labadan is the last
name of my mother Victoria Redillas Labadan; My father Julito Tumanao Gulfere
acknowledged me as his child since they were not married at that time of my
birth;
797. My mother Victoria R. Labadan and my father Julito T. Gulfere got
married eventually on February 28, 1998 at Dipolog City; Hence I was
subsequently legitimated because they have no legal impediments to marry each
other;
798. I am now processing the change of my last name from Labadan into
Gulfere and it is now submitted at the Philippine Statistics Authority for
correction;
799. I am willing to undertake and wait for the correction of my name while I
am applying for a position at the Philippine National Police;
800. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

GIOVANNI LABADAN GULFERE

(Affiant)
PRC ID#0188950-Criminologist
Valid until 10/24/2022

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN, CITIES OF DIPOLOG/DAPITAN
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020-Dipolog City
IBP NO.095495,11/22/2019 for CY2020
 ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. ESTAKA,DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, KEN P. CRISOSTOMO, of legal age, Filipino, single, a resident of Turno, Dipolog

City, after having been duly sworn to an oath in accordance with law, do hereby depose
and state, that:

801. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City. I effectively signed on February 28, 2019.
802. I applied to claim my terminal leave benefits and all other claims from the
hospital;
803. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demandable.
804. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2020, at Dipolog City, Philippines.

KEN P. CRISOSTOMO
(Affiant)
PRC ID#0721952
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN, CITIES OF DIPOLOG/DAPITAN
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020-Dipolog City
 IBP NO.095495,11/22/2019 for CY2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. ESTAKA,DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, DENNIS MART GUMAMAN DE LA PEÑA, of legal age, Filipino, single, a

resident of North Baybay, Galas, Dipolog City, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state, that:

805. I am an applicant for a position Patrolman, a member of the Philippine

National Police.
806. I am born May 17, 1998 at Dipolog City City.
807. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examininations for Criminology students in November 2019.
808. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
809. I have not been charged or convicted of any crime involving moral
turpitude.
810. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
811. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
812. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
 813. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

814. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

DENNIS MART GUMAMAN DE LA PEÑA

(Affiant)
PNP Clearance#TRA202001160000001725

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, NOEL DELA CRUZ DELARMENTE, of legal age, Filipino, single, a resident

of Purok Nawayan, San Jose, Dipolog City, Zamboanga del Norte after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

815. I am an applicant for a position Police Officer 1, as member of the

Philippine National Police.
816. I am born November 28, 1991 at Dapitan City.
817. I am a graduate of Bachelor of Science in Criminology at Jose Rizal
Memorial State University, Dipolog Campus in year 2019 and passed the
eligibility examininations for Criminology students in November 2019.
818. I have not been dishonorably discharged from the Armed Forces of the
Philippines or PNP or dismissed from the government service.
819. I have not been charged or convicted of any crime involving moral
turpitude.
 820. I agree to the automatic nullification of my application or appointment if
any of my documents and records contains falsehoods or misrepresentation.
821. I will not resign from service within 3 years from appointment or
reassignment for 5 years from the unit/region I served.
822. I hereby certify that the documents submitted are true and correct and
faithful reproduction of the originals.
823. I am physically and mentally fit to undergo rigorous training and activities
intended for member of the Philippine National Police.

824. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

NOEL DELA CRUZ DELARMENTE

(Affiant)
UMID#CRN-0111-3037377-4

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, I, EJ Agrivet Trading Corp, represented by Emma A. Mutia, of legal age,

Filipino, married, a resident of Dipolog City, Zamboanga del Norte after having been
duly sworn to an oath in accordance with law, do hereby depose and state, that:

825. I am the owner/buyer of a portion of parcel of land known as “A parcel of

land Lot No.1560-B, situated at Galas, Dipolog City, covered by Transfer
Certificate of Title No. 128-2018000311, containing an area of (1,633) square
meters”.
826. The above stated parcel of land is agricultural land .
 827. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
828. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
829. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

EMMA A. MUTIA
(Affiant)
ID#___________________

SUBSCRIBED AND SWORN to before me this ___ day of _________

2020, at Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, JOSEPHINE M. BLEN, TERESITA M. CADIGDIG, ELVIRA M.

MAYLON, MARIA LILIAN M. BAGON, RIZA M. BAGON, GLENDA M.
JARMIN, JOSEFA M. ELCAMEL, FERDINAND M. MAYLON, ROQUE D.
MAYLON, MELIZA M. BALILING, IMELDA DEGALA, WILLIAM D.
MAYLON,CHRISTINE SOLA, APRIL ROSE SOLA, JULIET E. MAYLON,
ALFRED ADRIAS and CHRISTIAN JHAY E. MAYLON, all of legal age, Filipinos, and
residents of Isis, Polanco, Zamboanga del Norte , after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:
 830. We are the owners of parcels of land known:
a. A parcel of land Lot No. 3708-B, Csd-09-002540 covered by
Katibayan ng Orihinal na Titulo Blg. P-48656 situated at
Fatima, Kalawit, Zamboanga del Norte, containing an area
of Twenty thousand three(20,003) square meters.
b. A parcel of land Lot No. 3708-A, Csd-09-002540 covered by
Katibayan ng Orihinal na Titulo Blg. P-40285 situated at
Fatima, Kalawit, Zamboanga del Norte, containing an area
of Forty two thousand four hundred sixty one(42, 461)
square meters.
c. A parcel of land Lot No. 3980, Gss-526(Case 2) covered by
Original Certificate of Title No. P-39322 situated at
Concepcion, Kalawit, Zamboanga del Norte, containing an
area of Forty five thousand Nine hundred eighty five(45,
985) square meters.
d. A parcel of land Lot No. 3975, Gss-526-Case 2 covered by
Original Certificate of Title No. P-40435 situated at Batong,
Labason, Zamboanga del Norte, containing an area of
Nineteen thousand Four hundred sixteen(19,416) square
meters.
e. A parcel of land Lot No. 5662-C, PSD-09-009584 covered
by Transfer Certificate of Title No. T-68841 situated at Isis,
Polanco, Zamboanga del Norte, containing an area of Ten
thousand Thirty(10,030) square meters.

831. The above stated parcels of land are agricultural land .

832. We, as owners, hereby undertake to comply with requirements of rules
and regulations to use the said parcel of land as agricultural land pending
application for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
833. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
834. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

JOSEPHINE M. BLEN TERESITA M. CADIGDIG

(Heir/Vendor) (Heir/Vendor)
PPPP ID#097210012-0462-00021 VIN#72020022AF1562TMC200002

ELVIRA M. ADRIAS JOSEFA M. ELCAMEL

(Heir/Vendor) (Heir/Vendor)
TIN#907-796-387 TIN#946-812-667

GLENDA M. JARMIN RIZA M. BAGON

(Heir/Vendor) (Heir/Vendor)
Philhealth ID#14-201249245-5 VIN#72100034AL2775RMB20000
MARIA LILIAN M. BAGON WILLIAM D. MAYLON
(Heir/Vendor) (Heir/Vendor)
PPPP ID#097210012-0459-00020 VIN#17180050AA2669WDM10000

FERDINAND D. MAYLON MELIZA M. BALILING

(Heir/Vendor) (Heir/Vendor)
ID#_____________________ ID#__________________________

ROQUE D. MAYLON APRIL ROSE [Link]/CHRISTINE [Link]

(Heir/Vendor) (Heir/Vendor)
ID#_________________

JULIET E. MAYLON IMELDA M. DEGALA

(Heir/Vendor) (Heir/Vendee)
Postal ID#PRNM83170053077P ID#_____________

CHRISTIAN JHAY E. MAYLON ALFRED M. ADRIAS

(Heir/Vendor) (Vendee)
ID#124579070079 ID#_____________________
JHAN CARLO E. MAYLON/ JHAY CARLL E. MAYLON /CHRISSHELL
JOYCE E. MAYLON/CAMILO E. MAYLON III represented by:

JULIET E. MAYLON
(AIF/Heir)

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ANGEL A. BARAZON, of legal age, Filipino, married, a resident of Palayan, Isis,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and state, that:

835. I am the owner/buyer of a portion of parcel of land known as Lot 4588-B

situated at Sto. Nino, Polanco, Zamboanga del Norte covered by TCT No. T-
48048, containing an area of 9,784 square meters.
836. The above stated parcel of land is agricultural land .
837. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
838. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
839. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

___________2020, at Dipolog City, Philippines.

ANGEL A. BARAZON
(Affiant)
ID#_________________
With photo

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZAMBOANGA DELNORTE
Book No. ____ VALID UNTIL 12-31-2021
Series of 2020 COMMISSION [Link]:ZDN-DPL-013-2020
PTR NO.1945342,1/02/2020
IBP NO.095495,11/22/2019 for 2020
ATTORNEY’S ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
 SUBSCRIBED AND SWORN to before me this 26th day of December 2019, at
Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, PATRICIA M. CRUZ, of legal age, Filipino, single, a resident of 45 Jensen St.,

Filinvest II, Brgy. Batasan Hills, Quezon City, Metro Manila , after having been duly sworn to
an oath in accordance with law, do hereby depose and state, that:

840. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City. I effectively signed on December 13, 2019.
841. I applied to claim my terminal leave benefits and all other claims from the
hospital;
842. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demadable.
843. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2020, at Dipolog City, Philippines.
 PATRICIA M. CRUZ
(Affiant)
PRC ID#0143551-Licensed Physician
With photo

SUBSCRIBED AND SWORN to before me this __th day of _________ 2020, at

Dipolog City.

Doc. No
Page No.
Book No.
Series of 2020

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JEGGER BUSCA PADELA, of legal age, Filipino, married, a resident of Lower Gumay, Piñan,
Zamboanga del Norte after having been duly sworn in accordance with law, hereby depose and
state:

That I am the owner and possessor of licensed firearms, described as follows:

MAKE KIND FA LIC. NO. SERIAL NO.

PISTL GLCK 545835I2289354 AACF791

PISTL ARMSCOR 0545835I01158469 959847

That the registration of abovementioned firearms was not renewed and already expired ; that
the Firearms and Explosive Office of the Philippine National Police could list the firearms as
unlicensed/revoked.

That I request the said office to life the said status and indicate that the firearms are lost.

That I undertake this affidavit to support for the loss of the said firearms and report if the
firearms are recovered. That, I would immediately process the renewal of its license.

As such, I am executing to attest to the truth of the foregoing statements and for other legal
purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of __________ 2020,
at Dipolog City.

JEGGER BUSCA PADELA

(Affiant)

AFP ID# A19-E-199331

SUBSCRIBED AND SWORN to before me this ___ day of _________ 2020, at Dipolog City.

Doc. No.__
Page No.__
Book No.__
Series of 2020
 I, CRESENCIA O. CORDUA, of legal age, Filipino, married, a resident of Polo, Dapitan
City, after having been duly sworn to an oath in accordance with law, do hereby depose
and state, that:

844. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City. I effectively retired on March 7, 2019.
845. I applied to claim my terminal leave benefits and all other claims from the
hospital;
846. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demadable.
847. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

December 2019, at Dipolog City, Philippines.

CRESENCIA O. CORDUA
(Affiant)
OSCA ID#005110-Dapitan City
With photo

SUBSCRIBED AND SWORN to before me this __th day of December 2019, at

Dipolog City.

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, CRESENCIA O. CORDUA, of legal age, Filipino, married, a resident of Polo, Dapitan

City, after having been duly sworn to an oath in accordance with law, do hereby depose
and state, that:

848. I am a former employee of Dr. Jose Rizal Memorial Hospital, Dapitan

City. I effectively retired on March 7, 2019.
849. I applied to claim my terminal leave benefits and all other claims from the
hospital;
850. I hereby authorized the agency to deduct all my financial obligations from
my claims. If there is any final judgment on disallowance against me, I am willing
to refund all obligations due and demadable.
851. I am executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

December 2019, at Dipolog City, Philippines.

CRESENCIA O. CORDUA
(Affiant)
OSCA ID#005110-Dapitan City
With photo

SUBSCRIBED AND SWORN to before me this __th day of December 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, EDWIN DENAGUET, of legal age, Filipino, married, a resident of Sta. Felomina,

Dipolog City, represented by Attorney-in-Fact REGINA DALMAN , after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

852. I am the owner/buyer of a parcel of land known as Lot 4639-A situated at

San Miguel, Polanco, Zamboanga del Norte covered by TCT No. T-87336,
containing an area of 13,907 square meters.
853. The above stated parcel of land is agricultural land .
854. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
855. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
856. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 26th day of

December 2019, at Dipolog City, Philippines.

REGINA M. DALMAN
(Attorney-in-Fact/Affiant)
Postal ID # M83170227054
With photo

SUBSCRIBED AND SWORN to before me this 26th day of December 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF MARITAL STATUS

I, JULAH OBORDO PASQUINELLY, of legal age, Filipino, married to THOMAS A.

PASQUINELLY, a resident of Lawaan, Dawo, Dapitan City, represented by Attorney-in-Fact
JOSEPH ACABAL, after having been duly sworn to an oath in accordance with law, do
hereby depose and state, that:

I, JULAH OBORDO PASQUINELLY, is married to THOMAS A.

PASQUINELLY, an American citizen;

I purchases a portion of parcel of land known Lot 522-H-8 situated in Lawaan,

Dapitan City covered by Transfer Certificate of Title No. T05118. The said portion of
parcel of land is covered by Deed of Absolute Sale notarized by Atty Rolando C.
Tesoro,Jr. per Doc No. 1844, Page No. 55, Book No. 4, Series of 2019;

The name of my spouse is not recorded in the said Deed of Absolute Sale;

I am executing this affidavit to attest to the truth of the foregoing statements and
for entry of the name of my spouse in the Certificate of title and whatever legal purposes
this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2019, at Dipolog City, Philippines.

JOSEPH ACABAL
(Affiant)
ID#___________________

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LUCENIA ADRIAS-ARCINUE, of legal age, Filipino, married, a resident of #170

Avenida Rizal West, Poblacion, Lingayen, Pangasinan, represented by Attorney-in-Fact
ARTIMON PACHEO, resident of Lot 15, Blk 2, Gardenville Subd. Tangub, Bacolod City , after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

857. I am the owner, being the heir of Nicanor Adrias and Bonifacia Eluna-
Adrias of a parcel of land known as Lot 4660-A situated at San Miguel, Polanco,
Zamboanga del Norte covered by TCT No. T-66220, containing an area of 33,455
square meters.
858. The above stated parcel of land is agricultural land .
859. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
860. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
861. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2019, at Dipolog City, Philippines.

ARTIMON PACHEO
(Affiant)
DL#F01-13-002128
 SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LUCENIA ADRIAS-ARCINUE, of legal age, Filipino, married, a resident of #170

Avenida Rizal West, Poblacion, Lingayen, Pangasinan, represented by Attorney-in-Fact
ARTIMON PACHEO, resident of Lot 15, Blk 2, Gardenville Subd. Tangub, Bacolod City , after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

862. I am the owner, being the heir of Nicanor Adrias and Bonifacia Eluna-
Adrias of a parcel of land known as Lot 4673 situated at Guinles, Polanco,
Zamboanga del Norte covered by TCT No. T-4886, containing an area of 23,351
square meters.
863. The above stated parcel of land is agricultural land .
864. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
865. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
866. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2019, at Dipolog City, Philippines.

ARTIMON PACHEO
(Affiant)
DL#F01-13-002128
 SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, LUCENIA ADRIAS-ARCINUE, of legal age, Filipino, married, a resident of #170

Avenida Rizal West, Poblacion, Lingayen, Pangasinan, represented by Attorney-in-Fact
ARTIMON PACHEO, resident of Lot 15, Blk 2, Gardenville Subd. Tangub, Bacolod City , after
having been duly sworn to an oath in accordance with law, do hereby depose and state,
that:

867. I am the owner, being the heir of Nicanor Adrias and Bonifacia Eluna-
Adrias of a parcel of land known as Lot 4660-A situated at San Miguel, Polanco,
Zamboanga del Norte covered by TCT No. T-66220, containing an area of 33,455
square meters.
868. The above stated parcel of land is agricultural land .
869. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
870. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
871. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of
__________ 2019, at Dipolog City, Philippines.

ARTIMON PACHEO
(Affiant)
DL#F01-13-002128

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, JANE LIM-SY and REYMAN KRIST SY, of legal age, Filipinos, spouses,
residents of Upper Turno, Dipolog City Zamboanga del Norte, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That we are the buyers and possessors of a parcel of land, known as Lot
No.3638-B covered by Transfer Certificate of Title No. T-80487 containing an area of
11,482 square meters situated at Adante, Piñan, Zamboanga del Norte.

That we warrant not to change the actual use of the property from agricultural
land use to some other uses or purposes.

That neither in the future, will we decide to change its use from agricultural to
residential, commercial or industrial, we undertake to comply the documentary
requirements for Land Use Conversion Order, the application of which, to be filed before
DAR, Regional Office, Zamboanga City/DAR, Central Office, Quezon City;

That we are executing this affidavit in good faith in order to attest the foregoing.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this _____

day of _____ 2019, at Dipolog City, Philippines.

REYMAN KRIST SY JANE LIM-SY

(Affiant) (Affiant)
ID#___________________ ID#________________________

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES,CPA

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JERAN DUROIN HALLARSIS, of legal age, Filipino, married, a resident of

Poblacion, Margosatubig, Zamboanga del Sur, after having been duly sworn to an oath
in accordance with law, do hereby depose and say:

That I am the authorized driver of the motor vehicle involved in a vehicular

accident on October 18, 2019 at around or about 9am, along National Highway,
Lingasad, Polanco, Zamboanga del Norte, described as follows:

Foton Tornado utility vehicle bearing Temporary Plate No. 090108, Engine No.
BJ493QF019325, Chassis No. LVBV3ABBXFJ029772 registered in the name of
Department of Agriculture;

That,the said vehicle was allegedly involved in accident with another vehicle
described as Honda Wave 110, color black, Temporary Plate No. 090102 driven by Ruffy
Bembol Erasmo, a resident of San Nicolas, Dapitan City, Zamboanga del Norte.

That on the same date, the above mentioned vehicles were impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle registered to
Department of Agriculture with the undertaking that I shall make the same available to
the Honorable Prosecutor or any authority in connection with any investigation involving
it anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

JERAN DUROIN HALLARSIS

(Affiant)
Driver’s License#J04-12-000532
Valid until 10/29/2022

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, RUENA T. LACAYA-GUILLENA, of legal age, Filipino, married to Glen

Guillena, resident of Guinles, Polanco, Zamboanga del Norte; and ROSERIC T.
LACAYA-DAGPIN, of legal age, Filipino, married to Rolly Dagpin, resident of San
Antonio, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That we are the owner and possessor of a parcel of land, known as Lot No. 5746-
B-1-C covered by Transfer Certificate of Title No. T-60856 containing an area of 9,773
square meters situated at Guinles, Polanco, Zamboanga del Norte.

That with regard to the area we have received, the whole/portion of the above
described parcel of land, we warrant ourselves not to change the actual use of the
property from agricultural land use to some other uses or purposes.

That in the future, we will decide to change its use from agricultural to residential,
commercial or industrial, we undertake to comply the documentary requirements for
Land Use Conversion Order, the application of which, to be filed before DAR, Regional
Office, Zamboanga City/DAR, Central Office, Quezon City;

That we are executing this affidavit in good faith in order to attest the foregoing.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this _____

day of _____ 2019, at Dipolog City, Philippines.

RUENA L. GUILLENA ROSERIC L. DAGPIN

(Affiant) (Affiant)
UMID CRN#006004072180 PRC ID#9105643

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ELLEN A. OLARIO, of legal age, Filipino, married, a resident of Pob. South,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the mother of the driver of the motor vehicle involved in a vehicular
accident on October 2, 2019 at around or about 6:45pm, along National Highway, Pob.
North, Polanco, Zamboanga del Norte, described as follows:

Motor Vehicle-Isuzu Wagon Hilander bearing a Plate No. GLV-886 registered in

the name of Elmo Olario;

That,the said vehicle was allegedly involved in accident with another vehicle Sym
Bonus X with Temp Plate No. 14865 driven by Juver Iloc Dungog, a resident of San
Antonio, Polanco, Zamboanga del Norte.

That on the same date, the above mentioned vehicle registered to Elmo Olario was
impounded by the Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle registered to my
spouse as owner with the undertaking that I shall make the same available to the
Honorable Prosecutor or any authority in connection with any investigation involving it
anytime.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

ELLEN A. OLARIO
(Affiant)
Driver’s License#J01-97-024323

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, DEXTER M. MORENO, of legal age, Filipino, married, a resident of Sinai,

Sergio Osmena, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the driver of the motor vehicle involved in a vehicular accident on

September 16, 2019 at around or about 5:55pm, along National Highway, Lingasad,
Polanco, Zamboanga del Norte, described as follows:

Motor Vehicle-Isuzu Truck Elf bearing a Plate No. WQW338

That,the said vehicle was allegedly involved in accident with another vehicle
Honda XRM 125, bearing Temp. Plate No. 100105, Chassis No. KPY00131770 driven
by Roger O. Dalap, a resident of Manukan, Zamboanga del Norte.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

DEXTER M. MORENO
(Affiant)
Pag-ibig Loyalty Card No. 1212-1098-6181

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ERLINDA R. TOTAo, single, a resident of Poblacion, Manukan, Zamboanga

del Norte, of legal age, Filipino, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

872. I am the buyer of a parcel of land known as Lot 449-B, Psd-097203-

021077 situated at New Tambo, Katipunan, Zamboanga del Norte covered by
TCT No. T-52391, containing an area of 1,430 square meters.
873. The above stated parcel of land is agricultural land .
874. I, as buyer, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
875. I fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
876. I am executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __th day of

__________ 2019, at Dipolog City, Philippines.

ERLINDA R. TOTAO
(Affiant)
ID#__________________

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.
Doc No. _____ IVO M. MANDANTES
Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF CITIZENSHIP

I, ANGIE S. KE, of legal age, Filipino, married to Hushui C. Ke, a resident of

Depane, Manukan, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am a Filipino citizen and national while my spouse Hushui C. Ke is a

Chinese citizen;

That this affidavit is executed to confirm the needed correction of Deed of

Absolute Sale notarized by Ivo Mandantes per Doc. No.929, Page No.91, Book [Link],
Series of 2019;

That this is further executed to attest the truthfulness of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

ANGIE S. KE
(Affiant)
ID#PRN-M83190138619

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.
Doc No. _____ IVO M. MANDANTES
Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, EMMA A. MUTIA, of legal age, Filipino, married, a resident of Galas, Dipolog

City, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and say:

That I am the owner of the motor vehicle involved in a vehicular accident on

September 10, 2019 at around or about 7:50am, along National Highway, Obay, Polanco,
Zamboanga del Norte, described as follows:

Motor Vehicle-Isuzu Truck Elf bearing a Plate No. GSK 440

 That,the said vehicle was allegedly involved in accident with another vehicle
Motorstar Color Red white and black bearing Plate No. 09100422738 driven by Jerry
Belbestre Cedeno who bumped us(with Marinette M. Remis).

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

DEMETRIO CARPO GARCIA,JR

(Affiant)
DL#J01-99—28570 until 5/21/24

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, GERONIMA O. MABILOG, widow, a resident of Barra, Dipolog City,

Zamboanga del Norte; DEOGRACIAS D. ORDINARIA, married, a resident of Minaog,
Dipolog City; AURORA D. ORDINARIA, single, a resident of Barra, Dipolog City,
Zamboanga del Norte and JUANITO D. ORDINARIA, SR., married, a resident of Barra,
Dipolog City, Zamboanga del Norte; all of legal age, Filipinos, after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:
 877. We are the heirs of Jose Ordinaria and Benita Daguayan and executed
Extrajudicial Settlement of Estate notarized by Eulogio Lagudas per Doc.
No.1181, Page No. 106, Book No.39, Series of 2019.

878. The notarized document also involved a parcel of land known as Lot Lot
2330-G covered by TCT No.(T-23426)728, situated at Sinaman, Dipolog City,
Zamboanga del Norte;
879. The above stated parcel of land is agricultural land .
880. We, as heirs, hereby undertake to comply with requirements of rules and
regulations to use the said parcel of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
881. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
882. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of __________ 2019, at Dipolog City, Philippines.

GERONIMA O. MABILOG AURORA D. ORDINARIA

(Affiant) (Affiant)
TIN#156305267 TIN#129862618

DEOGRACIAS D. ORDINARIA JUANITO D. ORDINARIA

(Affiant) (Affiant)
TIN#137703405 OSCA#3829

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
Republic of the Philippines}
City of Dipolog }S.S.

STATEMENT OF CLAIMS

We, MICHELLE K. SORRONDA and ERNESTO B. SORRONDA, JR, spouses,

of legal age, Filipinos, and residents of Block 8, Lot 3, Cydric Heights Subd., Dicayas,
Dipolog City, after having been duly sworn to an oath in accordance with law, do hereby
depose and state, that:
 883. We are passengers of the ill-fated MV Lite Ferries 16 that caught on fire at
sea on 28 August 2019 at the vicinity of Tag-ulo Point, Dapitan City;
884. We are on board together with the following personal properties:
a. Identification Cards like Passports, Bank Passbook
b. Laptop Asus I Series,
c. External Hard Drive
d. Cellular Phones namely Huawei 3i and Samsung A20;
e. Cash of P20,000.00
f. TOYOTA AVANZA 1.3E, color Dark Blue SE, with CS No.:P3N929,
Engine No.1NRGO29773
885. We are with these properties when the said MV Lite Ferries 16 caught fire
and subsequently these personal properties were also caught on fire and lost.
886. These above-stated properties are valued as follows:
a. Identification Cards like Passports, Bank Passbook=P1,250:00
b. Laptop Asus I Series=P32,000.00
c. External Hard Drive=P2,900.00
d. Cellular Phones namely Huawei 3i with price of P18,000.00 and
Samsung A20 with price of P12,000.00;
e. Cash of P20,000.00
f. TOYOTA AVANZA 1.3E, color Dark Blue SE, with CS No.:P3N929,
Engine No.1NRGO29773 which was purchased only on August 27,
2019 with purchase price of P914,000.00;
887. The total value of the identified personal properties lost is Philippine
currency of 1,000,150.00;
888. We are now filing this statement of claims before MV Lite Ferries 16 and
its operator Danilo Lines Incorporated with address of San Sebastian, Samboan,
Cebu.
889. We are attaching the proofs of ownership and loss of abovestated
properties;
890. We are executing this affidavit to attest to the truth of the foregoing
statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __th day
of __________ 2019, at Dipolog City, Philippines.

MICHELLE K. SORRONDA ERNESTO B. SORRONDA,JR

(Affiant) (Affiant)
Passpport#EC8062457 Driver’s License#K11-97-0026778

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.
Doc No. _____ IVO M. MANDANTES
Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

We, AIDA G. GORION, married, a resident of Marapong, Sergio Osmeña,

Zamboanga del Norte, CLEMENTINO I. AGIAS, JR, widower, a resident of Guiwan,
Zamboanga City, FRANCISCA A. QUISEL, married, a resident of Silawe, Polanco,
Zamboanga del Norte and TITA A. MAINQUE, married, a resident of Pob. North,
Polanco, Zamboanga del Norte; all of legal age, Filipinos, after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

891. We are the heirs of Clementino Agias and Josefina Intic Agias and
executed Extrajudicial Settlement of Estate with Simultaneous Sale notarized by
Elma L. Awit per Doc. No.2172, Page No. 6, Book No.7, Series of 2017.
892. The notarized document also involved the following parcels of land:Lot
4905-B-1 covered by TCT No.T-69379, Lot 4905-B-2 covered by TCT No.T-
69380, parcel of land covered by TCT No.T-15815, Lot 6339-B and still covered
by OCT No.4237, a parcel of land covered by TCT No.T-15814, and parcel of
land covered by TCT No.T-12064, all situated at Silawe, Polanco, Zamboanga del
Norte;
893. The above stated parcels of land are agricultural lands .
894. We, as heirs, hereby undertake to comply with requirements of rules and
regulations to use the said parcels of land as agricultural land pending application
for reclassification and plant them trees and agricultural products with
introduction of improvements without disturbing the agricultural use and purpose
of the parcels of land.
895. We fully understand that any violation of the use of the land or any
falsification or misrepresentation of the information herein stated and in the
documents we submitted shall subject us to actions by filing of the appropriate
civil, criminal and/or administrative complaint against me.
896. We are executing this affidavit to attest to the truth of the foregoing
statements and for subdivision of said parcels of land and for titling and whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this __th day
of __________ 2019, at Dipolog City, Philippines.

TITA AGIAS-MAINQUE
(Affiant)
For herself, and as AIF of Aida A. Gorion, Francisca A. Quisel, and Clementino Agias,Jr
PRC ID#080776 valid until 2/6/2020

SUBSCRIBED AND SWORN to before me this __ day of ____ 2019, at Dipolog

City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JUDITH A SALAVERIA of legal age, Filipino, married, a resident of Brgy

II, Katipunan, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:
 897. I am the Attorney-in-Fact of Mercy O. Llenado, Registered Owner of an
optical clinic doing business as Orozco Vision Care Optical Clinic located at
Herrera St., Central Barangay, Dipolog City, Zamboanga del Norte.
898. I failed to collect and remit contributions covering the period July 2013
until July 2019 in violation of “Home Development Mutual Fund Law of
1980”(P.O.1752) and “Home Development Mutual Fund Law of
2009”(R.A.9679).
899. The information and statements declared in the payroll, remittance
schedule and other documents I submitted to Pag-IBIG Fund are true and correct.
900. I hereby undertake to comply with the terms and conditions of the plan of
payment I submitted to and approved by Pag-IBIG Fund.
901. In the event a Pag-IBIG Fund member or his/her legal heirs file/s a claim
upon the occurrence of any of the grounds for membership termination provided
in R.A. 9679 and during the period of the approved plan of payment of Orozco
Vision Care Optical Clinic, I, as Registered Owner represented by Attorney-in-
Fact, hereby agree to pay upfront what is due to member and remit the same to
Pag-IBIG Fund.
902. I fully understand that any violation of the approved plan of payment or
any falsification or misrepresentation of the information herein stated and in the
documents I submitted shall result in the automatic termination of the plan of
payment and re-imposition of all penalties condoned without prejudice to the
filing of the appropriate civil, criminal and/or administrative complaint against
me.
903. I am executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 13th day
of August 2019, at Dipolog City, Philippines.

JUDITH A. SALAVERIA
(Affiant)
UMID ID#CRN-0111-5820797-4

SUBSCRIBED AND SWORN to before me this 13th day of August 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING
 I, DEMETRIO CARPO GARCIA,JR., of legal age, Filipino, married, a resident
of Brgy. Poblacion North, Polanco, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say:

That I am the driver of the motor vehicle involved in a vehicular accident on

July 5, 2019 at around or about 1pm, along Lailay St. corner Echaves St, of Estaka,
Dipolog City, Zamboanga del Norte, described as follows:

Motor Vehicle-Honda XRM Color Black, Bearing Plate No.0908-3348741 with

OR No.1593819441:

That,the said vehicle was allegedly involved in accident with another vehicle
Motorstar Color Red white and black bearing Plate No. 09100422738 driven by Jerry
Belbestre Cedeno who bumped us(with Marinette M. Remis).

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day

of _____ 2019, at Dipolog City, Philippines.

DEMETRIO CARPO GARCIA,JR

(Affiant)
DL#J01-99—28570 until 5/21/24

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.
 AFFIDAVIT OF UNDERTAKING

I, ELISA P. PESTAÑAS, of legal age, Filipino, a resident of Owaon, Dapitan

City, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and say:

That I am the Branch Manager of DES Appliance who sold motor vehicle to MM
O. Padao who was involved in a vehicular accident on June 27, 2019 along Kagatan
Road, Miputak, Dipolog City, Zamboanga del Norte at around 12:45am, described as
follows:

Motor Vehicle-Yamaha Sniper 150 Color Blue with Gray Black bearing
Temporary Plate [Link]-0474136 with engine No. G3E6E-0474136 :

That,the said vehicle was allegedly involved in accident with another parked
vehicle.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this _____ day
of _____ 2019, at Dipolog City, Philippines.

ELISA P. PESTAÑAS
(Affiant)
ID#__________________________________

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MARVIN B. PAGLALUNAN, of legal age, Filipino, single, a resident of Brgy.

Guinles, Polanco, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the driver of the motor vehicle involved in a vehicular accident on

May 31, 2019 along National Highway of Sta. Filomena, Dipolog City, Zamboanga del
Norte at around 6:50pm, described as follows:

Motor Vehicle-Honda Wave Black bearing Plate No.1400SA with engine

No.KWY01109822 :

That,the said vehicle was allegedly involved in accident with another vehicle
Isuzu Pick up bearing Plate No. GLX334.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Dipolog City, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this _____ day
of _____ 2019, at Dipolog City, Philippines.

MARVIN B. PAGLALUNAN
(Affiant)
VIN#7210-0033D-D2890MBP10000

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CIDRIC S. UY, of legal age, Filipino, married, a resident of Gulayon, Dipolog

City, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and state, that:

904. I am a permanent employee of Zamboanga del Norte Provincial Health

Office assigned at Zamboanga del Norte Medical Center.

905. I am willing to receive my salaries and benefits as an employee of the

Provincial Government of Zamboanga del Norte for the months January to May
2019.

906. I hereby undertake to shoulder the penalty on remittances of my

contributions for the said salaries and benefits [Link], Pag-ibig(HDMF),
Philhealth and Bureau of Internal Revenue.

907. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 25th day
of June 2019, at Dipolog City, Philippines.

CIDRIC S. UY
(Affiant)
PRC ID#0284147
Date issued:10/10/1995

SUBSCRIBED AND SWORN to before me this 25th day of June 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, PETER R. JANITO, of legal age, Filipino, married, a resident of Brgy.

Magangon, Lingasad, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the owner and driver of the motor vehicle involved in a vehicular
accident on June 10, 2019 along National Highway of Brgy. Lingasad, Polanco,
Zamboanga del Norte at around 7 am, described as follows:

Motor Vehicle-Rusi bearing Plate No.0920984796 with engine

No.RW162FMJJA028674, Chassis No.RWCLPK206, Cert. of Registration
No.289381853:

That,the said vehicle was allegedly involved in accident with another vehicle
Honda 100 Temp. Plate No. MC-06-12782-TP driven by Renante Apoc.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this _____ day
of _____ 2019, at Dipolog City, Philippines.

PETER R. JANITO
(Affiant)
LTO Drivers License #J01-15-001932s

SUBSCRIBED AND SWORN to before me this ___ day of ____ 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, CIDRIC S. UY, of legal age, Filipino, married, a resident of Gulayon, Dipolog

City, Zamboanga del Norte, after having been duly sworn to an oath in accordance with
law, do hereby depose and state, that:

908. I am a permanent employee of Zamboanga del Norte Provincial Health

Office assigned at Zamboanga del Norte Medical Center.

909. I am willing to receive my first salary and benefits as an employee of the

Provincial Government of Zamboanga del Norte.

910. I hereby undertake to shoulder the penalty on remittances of my

contributions for my first salary and benefits [Link], Pag-ibig(HDMF),
Philhealth and Bureau of Internal Revenue.

911. I am executing this affidavit to attest to the truth of the foregoing

statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 2nd day of
May 2019, at Dipolog City, Philippines.

CIDRIC S. UY
(Affiant)
PRC ID#0284147
Date issued:10/10/1995

SUBSCRIBED AND SWORN to before me this 2nd day of May 2019, at Dipolog
City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, KRYZA MAE F. FERNANDEZ, of legal age, Filipino, single, a resident of

Purok Mangga, Sicayab, Dipolog City, after having been duly sworn to an oath in
accordance with law, do hereby depose and state, that:

912. I am the Registered Owner of BEN GABRIEL PISONET located at Purok

Naga, Minaog, Dipolog City, Zamboanga del Norte.
913. I operate the said enterprise in accordance with the authority given to the
business and permits it granted.
914. I certify, undertake and attest that I would comply all the policies,
ordinances and regulations of the Local Government of Dipolog City and pay all
taxes, licenses and permits due from my business/enterprise;
915. I fully understand that any violation thereof shall give right to filing of the
appropriate civil, criminal and/or administrative complaint against me.
916. I am executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 30th day
of April 2019, at Dipolog City, Philippines.

KRYZA MAE F. FERNANDEZ

(Affiant)
ID#_______________________________

SUBSCRIBED AND SWORN to before me this 30th day of April 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, ERLINDA R. TOTAO, of legal age, Filipino, single, a resident of Poblacion,

Manukan, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and state, that:

917. I am the Registered Owner of a RTW establishment/enterprise doing

business as STEFF Cell Shoppe and Fashion Haus located at Caridad Building,
Poblacion, Manukan, Zamboanga del Norte.
918. I failed to collect and remit contributions covering the period May and
August 2015; March and July 2016; October, November and December 2018; and
January, February and March 2019 in violation of “Home Development Mutual
Fund Law of 1980”(P.O.1752) and “Home Development Mutual Fund Law of
2009”(R.A.9679).
919. The information and statements declared in the payroll, remittance
schedule and other documents I submitted to Pag-IBIG Fund are true and correct.
920. I hereby undertake to comply with the terms and conditions of the plan of
payment I submitted to and approved by Pag-IBIG Fund.
921. In the event a Pag-IBIG Fund member or his/her legal heirs file/s a claim
upon the occurrence of any of the grounds for membership termination provided
in R.A. 9679 and during the period of the approved plan of payment of STEFF
Cell Shoppe and Fashion Haus, I, as Registered Owner hereby agree to pay
upfront what is due to member and remit the same to Pag-IBIG Fund.
 922. I fully understand that any violation of the approved plan of payment or
any falsification or misrepresentation of the information herein stated and in the
documents I submitted shall result in the automatic termination of the plan of
payment and re-imposition of all penalties condoned without prejudice to the
filing of the appropriate civil, criminal and/or administrative complaint against
me.
923. I am executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purposes this may serve

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 29th day
of April 2019, at Dipolog City, Philippines.

ERLINDA R. TOTAO
(Affiant)
Voter ID#VIN72020009A-J0875ERT20000

SUBSCRIBED AND SWORN to before me this 29`th day of April 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, MELANIE E. PENADOS, of legal age, Filipino, married, a resident of Obay,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner and driver of the motor vehicle involved in a vehicular
accident on March 31, 2019 along Barangay Road of Don Jose Aguirre, Manukan,
Zamboanga del Norte at around 8:40 PM, described as follows:
 Motor Vehicle-Fuso Expedition Wagon, Color Black, Bearing Plate No. XAE543,
Engine No. 4D32-524344;

That,the said vehicle was involved in accident with another vehicle Honda
TMXS2J with Temporary Plate No. 11931.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Manukan, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 10th day
of April 2019, at Dipolog City, Philippines.

MELANIE E. PENADOS
(Affiant)
ID#_______________________

SUBSCRIBED AND SWORN to before me this 10th day of April 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, DANILO P. OBNIMAGA, of legal age, Filipino, married, a resident of Brgy.

Poblacion, Sibutad, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the owner and driver of the motor vehicle involved in a vehicular
accident on April 4, 2019 along National Road of Brgy. Sto. Niño, POlanco, Zamboanga
del Norte at around 12:05 PM, described as follows:
 Motor Vehicle-Isuzu-Mux 4x2 bearing Temp Plate#DO D620 with
Engine#4JJRP1707:

That,the said vehicle was involved in accident with another vehicle Hyundai i10
GLS 1.1L MT with Plate Number NCO563 driven by Efren M Cayongcong.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 4th day of
April 2019, at Dipolog City, Philippines.

DANILO P. OBNIMAGA
(Affiant)
LTO Drivers License #K12-96-005705 VALID UNTIL 1/21/23

SUBSCRIBED AND SWORN to before me this 4th day of April 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT

I, EMMANUEL G. ABRASADO, of legal age, Filipino, married, a resident of

Purok 2, La Victoria, La Libertad, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and say:
 That I am an elected Barangay Kagawad of La Victoria, La Libertad, Zamboanga
del Norte;

That I was serving my first, complete, and full term since December 1, 2013 until
June 30, 2018;

That I certify that I was not employed in the government during my term or I did
not receive any form of compensation/salary, except for the honorarium as Barangay
Kagawad of La Victoria, La Libertad, Zamboanga del Norte;

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 5th day of
March 2019, at Dipolog City, Philippines.

EMMANUEL G. ABRASADO
(Affiant)
Driver’s License#J01-14-001533

SUBSCRIBED AND SWORN to before me this 5th day of March 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
PTR#1699532-Dipolog City-1/3/2019
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT

I, Roger S. ABelleria, of legal age, Filipino, married, a resident of Brgy. Isis,

Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:
 That I am the owner and driver of the motor vehicle involved in a vehicular
accident on February 6, 2019 along National Road of Brgy. Isis, POlanco, Zamboanga
del Norte at around 8:30 PM, described as follows:

Motor Vehicle –Suzuki PlateNo. GRV 408 with Chassis Number DB7IT-308467:

That,the said vehicle was involved in accident with another vehicle Kawasaki
bearing plate number 100105.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 8th day of
February 2019, at Dipolog City, Philippines.

ROGER S. ABELLERIA
(Affiant)
LTO Drivers License #J01-93-016146

SUBSCRIBED AND SWORN to before me this 8th day of February 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF
UNDERTAKING
 I, Roger S. ABelleria, of legal age, Filipino, married, a resident of Brgy. Isis,
Polanco, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am the owner and driver of the motor vehicle involved in a vehicular
accident on February 6, 2019 along National Road of Brgy. Isis, POlanco, Zamboanga
del Norte at around 8:30 PM, described as follows:

Motor Vehicle –Suzuki PlateNo. GRV 408 with Chassis Number DB7IT-308467:

That,the said vehicle was involved in accident with another vehicle Kawasaki
bearing plate number 100105.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Polanco, Zamboanga del Norte;
That I hereby request for the release of the said motor vehicle I owned with the
undertaking that I shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 8th day of
February 2019, at Dipolog City, Philippines.

ROGER S. ABELLERIA
(Affiant)
LTO Drivers License #J01-93-016146

SUBSCRIBED AND SWORN to before me this 8th day of February 2019, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. _____ NOTARY PUBLIC FOR ZN
Book No. ____ UNTIL 12-31-2019
Series of 2019 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT
 I, TERESITA OLVIS, of legal age, Filipino, single, a resident of Brgy. Turno,
Dipolog City, Zamboanga del Norte, after having been duly sworn to an oath in
accordance with law, do hereby depose and say:

That I am the registered owner of a parcel of land known as TCT NO. T-1224;

That I certify my grandmother Gabriela Yebanes has been long dead;

That further certify that there was no usufruct or any usufructuary rights granted
to any person has been revoked or has already expired.

That I certify as to the truthfulness of the foregoing.

Fdfdddxxxxxdffdddtddfdrttddc
IN WITNESS WHEREOF, I have hereunto affixed our signatures this 27th day
of December 2018, at Dipolog City, Philippines.

TERESITA OLVIS
(Affiant)
ID#________________________

SUBSCRIBED AND SWORN to before me this 27th day of December 2018, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. ___ NOTARY PUBLIC FOR ZN
Book No. __ UNTIL 12-31-2019
Series of 2018 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF
UNDERTAKING

I, JILL E. DAHONOS, of legal age, Filipino, single a resident of Brgy. Siare,

Sindangan, Zamboanga del Norte, after having been duly sworn to an oath in accordance
with law, do hereby depose and say:

That I am an applicant for a position before the Armed Forces of the Philippines:

That my civil status is single and that I have no child or dependent that I need to
provide support;

That I certify as to the truthfulness of the foregoing.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 19th day
of November 2018, at Dipolog City, Philippines.
 JILL E. DAHONOS
(Affiant)
PRC ID#0137802
Valid until 8/8/2020

SUBSCRIBED AND SWORN to before me this 22nd day of July 2018, at

Dipolog City.

Doc No. _____ IVO M. MANDANTES

Page No. ___ NOTARY PUBLIC FOR ZN
Book No. __ UNTIL 12-31-2019
Series of 2018 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF
UNDERTAKING AND REQUEST FOR RELEASE

I, EDHEL JAY-R Q. ANDAG, of legal age, Filipino, single a resident of Brgy.

Oro, Dapitan City, after having been duly sworn to an oath in accordance with law, do
hereby depose and say:

That I am the driver of the motor vehicle involved in a vehicular accident on

July 21, 2018 along National Road of Brgy. Poblacion, Manukan, Zamboanga del Norte
at around 8:30 PM, described as follows:

Motorcycle -PlateNo. 090103 with Engine Number JEZCGE2869 registered

under the name of ADORAM B. CANOY:
 That, Mr. Andag while traversing to Dipolog City accidentally hit [Link]
Cabillo who suffered injuries and currently in the hospital.

That on the same date, the above mentioned vehicle was impounded by the
Philippine National Police of Manukan, Zamboanga del Norte;
That I hereby request for the release of Mr. Andag and the vehicle mentioned with
the undertaking that we shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, I have hereunto affixed our signatures this 22 nd day of

July 2018, at Dipolog City, Philippines.

EDHEL JAY-R Q. ANDAG

(Affiant)
LTO Drivers License #J01-1-009194

SUBSCRIBED AND SWORN to before me this 22nd day of July 2018, at

Dipolog City.

Doc No. 95 IVO M. MANDANTES

Page No. 41 NOTARY PUBLIC FOR ZN
Book No. I UNTIL 12-31-2019
Series of 2018 COMMISSION [Link]-DPL-022-2018
ROLL NO. 65014
LAPU-LAPU ST. DIPOLOG CITY

Republic of the Philippines}

City of Dipolog }S.S.

AFFIDAVIT OF
UNDERTAKING AND REQUEST FOR RELEASE

I, ANTONIO E. GANDASAN, of legal age, Filipino, married a resident of

Bayang, Gulayon, Dipolog City and FREDDIE VAILOCES, of legal age, Filipino, single
a resident of Dela Paz, Liloy, Zamboanga del Norte, after having been duly sworn to an
oath in accordance with law, do hereby depose and say:

That I am the owner of the involved in a vehicular accident on July 17, 2018 at
in front of Mandarin Storage Building Anahaw, Galas, Dipolog City at around1:55 pm,
 VEHICLE-1 - motorcab-PlateNo. JY-7241 driven by Robert Refugio
VEHICLE 2 - Mini-dump bearing Plate No. ADO5231- owner Antonio E.
Gandasan

That on July 17, 2018, the above mentioned vehicles were impounded or
apprehended by the Philippine National Police of Dipolog City, after the Mini dump with
Plate No. ADO5231 hit the motorcab in front of Mandarin Storage Building, Anahaw,
Galas, Dipolog City;

That we have settled the incident;

That we hereby request for the release of the vehicles mentioned with the
undertaking that we shall make the same available to the Honorable Prosecutor or any
authority in connection with any investigation involving it.

IN WITNESS WHEREOF, We have hereunto affixed our signatures this 18 th day

of July 2018, at Dipolog City, Philippines.

ANTONIO E. GANDASAN ROBERT REFUGIO

(Affiant) (Affiant)
CRN ID # 006-0074-1358-6

SUBSCRIBED AND SWORN to before me this 18th day of July 2018, at Dipolog
City.
Republic of the Philippines)
City of Dipolog ) S.S
X----------------- /

AFFIDAVIT OF UNDERTAKING

I, LEONILA E. OBNIMAGA, of legal age, Filipino, widow, a resident of

Poblacion, Sibutad, Zamboanga del Norte, after being duly sworn to an oath in
accordance with law, depose and state the following:

That I promise that my driver will submit for Driver’s Academy Training in (30)
days;

That I am executing this affidavit in good faith to attest to the above truth.

IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day of June

2018, at Dipolog City.

LEONILA E. OBNIMAGA
(Affiant)
SC ID # ________

SUBSCRIBED AND SWORN to before me this 27th day of June 2018, at

Dipolog City.
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, JAY PEE MONTAJES DUHAYLUNGSOD, of legal age, Filipino, single, a

resident of Poblacion North, Piñan, Zamboanga del Norte, after having been duly sworn
to an oath in accordance with law, do hereby depose and state, that:

1. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

2. I am now intending to enroll for the first semester of 2024-2025 School

Year; however I still have an outstanding obligation in the amount of
P4,500.00 with our College Department;

3. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P4,500.00 outstanding obligation
with the College Department within this School Year;

4. I have no intention of evading my obligation from the school or my

college department;

5. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12 th day of

August 2024, at Dipolog City, Philippines.

JAY PEE MONTAJES DUHAYLUNGSOD

(Affiant)
Philhealth ID#14-050271230-2
With photo & signature

SUBSCRIBED AND SWORN to before me this 12 th day of August 2024, at

Dipolog City.

DOC. NO.___
PAGE NO.___
BOOK NO.___
SERIES OF 2024
Republic of the Philippines}
City of Dipolog }S.S.

AFFIDAVIT OF UNDERTAKING

I, KHATE IAN CHESTER BUNGA IRAG, of legal age, Filipino, single, a

resident of P-9 Bañadero, Ozamis City, Misamis Occidental, after having been duly
sworn to an oath in accordance with law, do hereby depose and state, that:

1. I am a student of Jose Rizal Memorial State University-Dipolog City

Campus;

2. I am now intending to enroll for the first semester of 2024-2025 School

Year; however I still have an outstanding obligation in the amount of
P 9,560.00 with our College Department;

3. In view of my acceptance for enrollment pending payment of my

obligation, I undertake to pay the said P 9,560.00 outstanding obligation
with the College Department within this School Year;

4. I have no intention of evading my obligation from the school or my

college department;

5. I am executing this affidavit to attest to the truth of the foregoing

statements and whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12 th day of

August 2024, at Dipolog City, Philippines.

KHATE IAN CHESTER BUNGA IRAG

(Affiant)
DL#K04-19-000405
With photo & signature

SUBSCRIBED AND SWORN to before me this 12 th day of August 2024, at

Dipolog City.