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Affidavit of Undertaking Motor Vehicle DENR Confiscation:penaflor

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REPUBLIC OF THE PHILIPPINES )

MacArthur Leyte ……………….. )S.S.

AFFIDAVIT OF UNDERTAKING

I, RONA V. PEÑAFLOR, Filipino, of legal age, married and with present address at
Brgy. Batug, MacArthur, Leyte, after having been subscribed to an oath, depose and say:

1. That I am the owner of Mitsubishi - FUSO Truck, and most particularly described as
follows:

Plate No.: GJL468


CR No.: 153923722 dated 7/17/2013
MV File No.: 0716-00001452570

Engine No. 4D32570833


Chassis No. FE335EV-510061
Body Type Dropside

2. That I am attaching herewith a machine copy of the Deed of Absolute Sale notarized
by Atty. Crizalda Adonis-Balayan bearingDoc. No. 153; Page No. 33; Book 1; Series
of 2020, as proof of ownership over the above-described vehicle;

3. That the above-mentioned vehicle is under custody of the DENR-CENRO Palo since
last Nov. 23, 2020;

4. That I am applying for temporary Release of Vehicle;

5. That I had not been previously charged criminally and administratively for any
forestry violation;

6. That the replacement cost of the above-mentioned vehicle is _____________________;

7. That this motor vehicle is being used by my family so as to earn an income hence I am
fervently requesting the good police officers to release the said motor vehicle in my
favor;

8. That I undertake to bring the motor vehicle to court ordered by the competent
authority without any conditions and promises not to
dispose/deliver/assign/waive/mortgage the same at any time during the
investigation /pendency of the case;

9. That to ensure the integrity and preserve the identity and present state of the vehicle;

In witness hereof, we hereby set my hand this 11 th day of January 2021, in MacArthur
Leyte, Philippines.

RONA V. PEÑAFLOR
Affiant

SUBSCRIBED AND SWORN to before me this 11th day of January, 2021. Affiant
exhibiting to me her driver’s License # H02-20-003138 as evidence of her identity.

Doc. No _____;
Page No _____;
Book No _____;
Series of 2021.

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