REPUBLIC OF THE PHILIPPINES )

QUEZON CITY, METRO MANILA) S.S.

AFFIDAVIT OF UNDERTAKING
(Induvidual/Sole Proprietor)

I, JOAN R. DOYO of legal age, Filipino, with residence and postal address at B27 L19 Grand
Acacia Groove Subd. Banay-Banay, Cabuyao, Laguna, after having been duly sworn to in accordance
with law, hereby depose and state:
1. That I am a licensed customs broker of Columbia Transport Inc. engaged in the business of
freight forwarding;
2. That I am presently applying for BIR CUSTOMS BROKER CLEARANCE
CERTIFICATE with the Bureau of Internal Revenue for accreditation purposes pursuant to
Department Order No. 12 series of 2014;
3. That I/We hereby undertake to comply with the duty to preserve and maintain all records
pertaining to my business operations for a period of ten (10) years and to allow access to
examination by the BIR, BOC, and the Fiscal Intelligence Unit of the Department of
Finance (DOFFIU);
4. That this affidavit is executed in order to attest to the truthfulness of the foregoing narration
of facts in compliance with the requirement of the BUREAU OF INTERNAL REVENUE
and the DEPARTMENT OF FINANCE as basis for the approval of our application for
importations and for whatever legal intents and purposes it may serve.
IN WITNESS WHEREORF, I am affixing my signature this ___ day of _________ 2014 in
Quezon City, Metro Manila.

_________________________
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this ___ day of _________ 2014 at Quezon
City, Metro Manila, Philippines. Affiant Exhibited to me his/her Tax Identification No.
_____________________.
Doc. No. ______
Book No. _____
Page No. ______
Series of ______