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Affidavit of Undertaking

1) Lovely Jay Baluyot voluntarily surrendered herself to the Philippine National Police for being a drug user in violation of the Dangerous Drugs Act of 2002. 2) She authorized the police to take her urine sample, photos, fingerprints, and other information to investigate her involvement with illegal drugs. 3) She committed to reforming herself, joining anti-drug activities, undergoing treatment, and reporting any drug-related information to authorities.

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Lovely Jay Baluyot
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216 views

Affidavit of Undertaking

1) Lovely Jay Baluyot voluntarily surrendered herself to the Philippine National Police for being a drug user in violation of the Dangerous Drugs Act of 2002. 2) She authorized the police to take her urine sample, photos, fingerprints, and other information to investigate her involvement with illegal drugs. 3) She committed to reforming herself, joining anti-drug activities, undergoing treatment, and reporting any drug-related information to authorities.

Uploaded by

Lovely Jay Baluyot
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Republic of the Philippines ]

Capas, Tarlac ] s.s

AFFIDAVIT OF UNDERTAKING

I, LOVELY JAY BALUYOT, Filipino, of legal age, single, presently residing at


0723 Sto. Cristo St., O’Donnell, Capas, Tarlac, after having been duly sworn in accordance
with law, hereby depose and state that:

1. On April 15, 2021 I went to the Philippine National Police with office address at Sto.
Domingo, Capas, Tarlac for the purpose of subjecting myself to voluntary surrender
as a user of dangerous drugs;

2. I voluntarily acknowledged that as a user of dangerous drugs, I have committed a


crime in violation of Republic Act No. R.A. No. 9165 or the “Dangerous Drugs Act
of 2002”;

3. I am authorizing Philippine National Police through its Laboratory Service to take my


urine sample and to conduct physical/medical examination for any purpose that it
may serve the Agency;

4. I am authorizing the Philippine National Police to take my photos, fingerprints (ten


prints) and any information in relation with my involvement in the proliferation of
illegal drugs as well as other information known to me about my cohorts;

5. I am committing to do the following:


a. I shall reform myself and resolve not to engage anymore in the illegal drug
business;
b. I further submit to record check and background investigation of Philippine
National Police and other law enforcement units, whenever necessary to prove
my truthfulness and integrity;
c. I shall join all anti-drug activities undertaken by the municipality Capas;
d. I shall report to the Tarlac Drug Abuse Treatment and Rehabilitation Center
once a week for a period of six (6) months and shall subject myself to any
random drug testing;
e. I shall immediately report all drug-related information to the authorities; and
f. I am willing to voluntarily submit myself for treatment and rehabilitation.

6. I understand and agree that my voluntary surrender and this waiver does not in any
way absolve me from any criminal liability nor shall it result in the removal of my
name from the list of drug personalities.
7. I hereby WAIVE any and all claims, criminal, civil, or administrative against the
Agency and officers thereof, and further RELEASE and DISCHARGE them from
any and all liability. Likewise, I hereby authorize Philippine National Police to utilize
the result of my urine sample for any legal purpose that it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 21st day of April 2021
at Capas, Tarlac, Philippines.

LOVELY JAY BALUYOT


Affiant
CTC No. 23327052
Issued at Capas, Tarlac
Issued on March 12, 2021

SUBSCRIBE AND SWORN to before me this 22nd day of April 2021 by Lovely Jay
Baluyot who exhibited to me her Community Tax Certificate Number as indicated below her
signed name.

ROXANNE PASCUAL
Notary Public

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