REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF __________________ ) SS.

AFFIDAVIT OF UNDERTAKING

I, (name)
______________________________________, of legal age and a resident of
(address)
___________________________________, in accordance with law, do hereby depose and state that;

(owner/authorized representative) ___________________________________

1. I am the _____________________________of (business name)
(business address)
located at ________________________________;
2. I am securing a business permit and license at the One Stop Shop Business Permit Application
and Renewal at the Municipality of Argao;
3. I am aware of the requirements for the application and renewal of business permit;
4. That one of the requirements for the said permit is building clearance;
5. And such clearance can only be issued with an approved Building and Occupancy permit of
the establishment issued by the Building Official of the Municipality of Argao;
6. That my business establishment lacks the aforementioned requirement/s and thus I swore to
comply within six (6) months upon signing this affidavit the requirements and all relevant
documents for the for the issuance of my business permit;
7. That the Local Government Unit of Argao and the Office of the Building Official shall not be
held liable for whatever incidents may occur on my establishment within the six month period
of compliance;
8. And that in the event that I have failed to comply all the necessary requirements within the
given period, I interpose no objection to the automatic suspension, cancellation or revocation,
as the case may be, of my business permit and license, and the subsequent closure of the
above-cited business establishment, if necessary;
9. That I am executing this affidavit for the purpose of issuance for Building Clearance for
Business Permit and License and to attest the truth of the foregoing facts.

In witness whereof, I have hereunto affixed my signature this _____ day of

______________________ at __________________.

_______________________________

Affiant

SUBSCRIBE AND SWORN TO before me this ______ day of _______________________, affiant

exhibiting to me his __________________________ issued at ______________________
on______________, to expire on _________________ as competent evidence of identity.

NOTARY PUBLIC
Doc No. _______
Page No._______
Book No._______
Series of _______