Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

DEED OF UNDERTAKING

            I, _____________________, Filipino, of legal age, single/married, of


_______________________, Cebu City, under oath depose and say:

1.    That I am the operator and registered owner of the _________________ public


utility jeepney (PUJ) with plate number __________, which collided with the PUJ
owned and operated by ___________________ sometime on
_________________, 2015 while my vehicle was being driven on the streets,
regrettably causing damage to Mr.____________’s vehicle due to the fault of my
driver;

2.    That I extend my sincere apologies to _____________. Accordingly, I own primary


responsibility to Mr. ______________ for the damage to his PUJ and undertake
and assure that I shall shoulder and satisfy any and all expenditures relating to the
repair of said PUJ, including but not limited to repairs;

3.    That I promise to pay the amount of __________________ Pesos


(PhP____________.00) to _________________ on or before ______________,
2015 in connection with my aforesaid obligation and should I fail to pay on or
before said date, the extent of my obligation on the repairs and idleness of the
vehicle to Mr. _________________ shall be _________________ Pesos
(Php_______________.00);

4.    I am executing this Undertaking after serious thought, without any fraud, force,
intimidation, or violence applied upon me to vitiate my consent and with full
knowledge of my rights under the law.

AFFIANT FURTHER SAYETH NAUGHT.

           (DATE), __________________, Cebu.

______________________________
ID Details: ______________

WITNESSES: _______________________       _______________________

ACKNOWLEDGMENT

BEFORE ME A NOTARY PUBLIC, for and in the City of _________, this ______
day of ___________________, 2015 personally came and appeared
____________________, whose identity is proven by his Voter’s ID above-stated, and he
acknowledged to me that the same is his free and voluntary act and deed.

            WITNESS MY HAND AND SEAL on the date and place first above written.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2015.

You might also like