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Accreditation Affidavit
PDEA affidavit for accreditation
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: FM-CSVlrd-21
REPUBLIC OF THE PHILIPPINES )
CITY OF ______________________)S.S
AFFIDAVIT OF UNDERTAKING
I,
____________________,
of
legal
age,
Filipino,
a
resident
of
_______________________, and the Owner/Operator of (name of entity) located at (address of
entity), after having been sworn in accordance with the law, do hereby depose and say:
That I undertake to perform the following duties and responsibilities:
a) Compliance with the requirements to all the provisions of Republic Act 9165
otherwise known as the “Comprehensive Dangerous Drugs Act of 2002”, and other
Implementing Rules and Regulations in transporting controlled substances and
assures that such law and regulations shall be faithfully complied with;
b) Secure PDEA accreditation and renewal thereof prior to expiration date;
c) Ensure that transport vehicles are properly operated, maintained and controlled
substance/s to be transported are secured;
d) Report and/or cause the reporting within twenty-four (24) hours from the occurrence
of any of incident of losses, theft, pilferage during transport of controlled substance/s
to the PDEA and/or concerned PDEA Regional Office, as the case may be; and
e) Ensure that appropriate ITDI/DOST Calibration Certificate/Test Report shall be made
available upon inspection by the PDEA at all times when required.
That, I am executing this Affidavit to attest the truth of the foregoing facts, for whatever
legal intent and purpose it may serve.
IN WITNESS HEREOF, I have unto set my hand this ______day of , 20________ at
_________, Philippines.
_____________________
Affiant
SUBSCRIBED AND SWORN to before me this ____day of _____________ at
__________Philippines. Affiant personally appeared before me exhibiting his/her Community
Tax Certificates (or any government issued ID No.) ________________ issued on
__________at________________.
Notary Public
Doc. No. ______
Page No. ______
Book No. ______
Series of _______