Affidavit of Undertaking FA

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Republic of the Philippines )

Quezon City ) S.S

AFFIDAVIT OF UNDERTAKING

[For Individual]

I, ______________________________________________ of legal age, ___________, Filipino


(Complete Name) (Civil Status)
Citizen, with residence and postal address at _____________________________________________
(Address)
after being sworn to in accordance with the law, do hereby depose and state that:

1. I applied for ________________________________________________________________


(Type (1 to 5) License To Own And Possess Firearm)
before the Firearms and Explosive Office of the Philippine National Police;

2. All the documents required for the aforementioned application which I submitted to the
Firearms and Explosive Office of the Philippine National Police is genuine and authentic;

3. Pursuant to the said application, I hereby undertake to pay within 30 days from notice the
amount of license and/or registration fee/s pursuant to the schedule of fees set forth for this purpose;

4. I fully understand that non-payment of the required fee shall be a ground for the cancellation
of my License To Own And Possess Firearm or my Firearm Registration;

5. I can be contacted through my mobile number ____________________________________,


landline number ______________________ or email address ________________________; and

6. I am freely and voluntarily executing this affidavit to attest to the truthfulness of the foregoing
statements and submit to the legal consequences thereof.

__________________________________
(Name and Signature of Affiant)
ID No.: ____________________________
Issued on: _________________________
At: _______________________________

SUBSCRIBED AND SWORN to before me this ____ day of _______________ 20___ in


___________________, Philippines. Affiant having exhibited to me his/her ID described and written
below her name as evidence of competent identity.

NOTARY PUBLIC

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