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Affidavit of Undertaking

The document is an affidavit of undertaking that provides information for a data privacy compliance form. It states that any false information provided is grounds for legal action and revokes the permit. It also agrees that personal data may be processed, profiled or shared for legal purposes.

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Edson Lacay
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1K views1 page

Affidavit of Undertaking

The document is an affidavit of undertaking that provides information for a data privacy compliance form. It states that any false information provided is grounds for legal action and revokes the permit. It also agrees that personal data may be processed, profiled or shared for legal purposes.

Uploaded by

Edson Lacay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES

CITY OF __________________

AFFIDAVIT OF UNDERTAKING
DATA PRIVACY LAW OF 2012
I, ___________________________________, legal age, __________________ and resident of __________
_______________________, after having been duly sworn to in accordance with the law, depose and say

1. That I am owner/applicant of _______________________________________________ located at __________


_____________________________________________________________

2. In compliance with the Data Privacy Law of 2012, the LGUs shall require the submission of an undertaking, similar to the
statement below, that also reminds applicants to provide correct information

3. I UNDERTAKE that all information in this application is true and correct based on my personal knowledge and authentic
records submitted to the City of Las Piñas. Any false or misleading information supplied, or production of fake/falsified
documents shall be grounds for appropriate legal action against me and automatically revokes the permit. I hereby agree
that all personal data (as defined under the Data Privacy Law of 2012 and its Implementing Rules and Regulations) and
account transaction information or records with the Local Government of Las Piñas may be processed, profiled or shared
to requesting parties or for the purpose of any court, legal process, examination, inquiry and audit or investigation of any
authority.

IN WITNESS WHERE OF, I have hereunto affixed my signature ______________________________ day of _____________
_______________________

___________________________
Name of Applicant

`SUBSCRIBED and sworn to before me, this _______ day of _______ in the City of Las Piñas of __________
____________ by ______________ with _______________ (Proof of identification No.) issued on _____________________
at ________________________ .

Doc No. NOTARY PUBLIC for _________________


Page No. Commision Serial No. ________________
Book No. Until December 31 __________________
Series No. Roll of Attorney _____________________
IBP No. _____/______/________
PTR No. ____/ ______/ ________

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