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Deed of Undertaking

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DEED OF UNDERTAKING

I, MR. JOEMAN T. DE VILLA, legal of age, Filipino, married and a resident of Basak
Mandaue City, under oath depose and state:

1. That I am the registered owner of the Yamaha Mio Sporty 40C5 with plate number
GA30229 which fiigured in an accident with Maria Michelle Cortes, of legal age,
Filipino, married and a resident of M.Q. Cuizon St., Alang-Alang, Mandaue City and
currently working at City Agriculture, Mandaue City.

2. That as per blotter by the Police Station 1/ Traffic Management Unit on about 6:30 in
the morning of July 15, 2021, while traveling along MC Briones St. Central Nautical Hi-
way Mandaue City heading towards the direction of Barangay Basak and right after the
intersection, I accidentallly bumped a crossing person in the person of Maria Michelle
Cortes heading across towards the opposite corner going to her work at City Agriculture
which caused significant physical body injuries;

3. That extend my sincere apologies to Mrs. Maria Michelle Cortes. Accordingly, I own
primary responsibility for the physical body injuries and assure that I shall shoulder and
satisfy any and all medical expenses but not limited to hospitalization.

4. That I am executing this undertaking without any fraud, force, intimidation, or


violence applied upon me to vitiate my consent and with full knowledge of any rights
under law.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ of ___________ in


Mandaue City, Cebu, Philippines.
Mr. Joeman T. De Villa
Affiant
Driver License No. ______

SUBSCRIBED AND SWORN to before me this ________ day of ____________ in


Mandaue City, Cebu, Philippines.

Doc. No.: _____


Page No.: _____
Book No.: _____
Series of 2021

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