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Affidavit of Undertaking (Fine)

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REPUBLIC OF THE PHILIPPINES)

CITY OF LIPA------------------------- )S.S.

AFFIDAVIT OF UNDERTAKING
I, __________________________________, of legal age, Filipino and currently detained
at the ________________________________________, after being sworn in accordance with
law, depose and state:
1. That, on _____________________, I was found guilty of violating Section 12, Article II
of Republic Act No. 9165 in Criminal Case no/s.
_________________________________ before the Regional Trial Court Branch __,
Lipa City, Batangas;

2. That, as such, I was sentenced to suffer the penalty of :

3. That, an Application for Probation was filed within the period provided for by the law
and as a requirement for the processing of the said probation, I need to settle the fine
amounting to a total of ____________________________________________
(Php ___________.00);

4. That, I am only depending on my family and relatives for the payment of the said fine
and unfortunately, I cannot pay the full amount of the said fine considering that our
family belongs to indigent families;

5. That, I am paying the amount of ______________________________ as my initial


payment of the said fine and I undertake to pay the remaining balance before the reading
of my probation order;

6. That 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 set my hand this ___________________,


2022 here at the City of Lipa, Philippines.

________________________________
Affiant

SUBSCRIBED AND SWORN to before me this ________________________ at Lipa


City, Batangas.

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