Republic of the Philippines Department of the Interior and Local Government National Police Commission NATIONAL HEADQUARTERS, PHILIPPINE

NATIONAL POLICE Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING
(Revised Form 2009)

I, _______________________________________________, of legal age, residing at __________________________ a bonafide member of Philippine National Police, presently assigned at _______________________ designated to the position as __________________
(Office/Unit) (Rank) (First Name) (Middle Name) (Last Name)

__________________________

effective

on

_________________________________

after

having duly sworn to in accordance with law, do hereby depose and state: That, I am an applicant for promotion to the rank of __________________________; That, my highest educational attainment in a recognized institution of higher learning is
___________________________________________________;
(Baccalaureate/Masters/Doctorate Degree)

That, my highest promotional eligibility is

______________________________________;
(NAPOLCOM Exam/CSC Prof/PO/PD 907/RA 1080)

That, my highest mandatory training is ___________________________________

which I
(Equivalence Accredited by DHRDD)

completed on _______________________________: That, all documents I have submitted to support my promotion are genuine and authentic and that all the originals are now with me for verification and/or comparison; That, I have no pending criminal nor administrative case or any other claim filed against me as of this date in any court, tribunal or quasi-judicial agency and there is no complaint proffered against me before the Ombudsman or the PLEB; That, if I should therafter learn that a criminal or administrative case has ben filed or pending, or that a complaint was proffered against me before the Ombudsman or the PLEB, I shall report the fact within five (5) days from knowledge to the Promotion Board through the Secretariat the complete statement of the present status of the case; That, I agree to the automatic nullification of my promotion and I hold myself liable for perjury, falsehood, misrepresentation or omission or act of dishonesty: a. If it would be discovered later on that a criminal or an administrative case was filed or is pending or, that a complaint was proffered against me before the Ombudsman or the PLEB and there was failure on my part to immediately inform the Board of the same; b. Or for any fraudulent, fake or tampered documents that I have submitted; That, I attest to the truthfulness of this undertaking and submit to the legal and administrative consequences thereof if ever the statements above are wanting in truth and in substance.
______________________________________

Affiant

Community Tax Cert No.______________________________ Dated:____________ Place:___________________________ SUBSCRIBED AND SWORN TO before me this ____ day of _______________, 2009, at ____________________________, Philippines. ___________________________________ (Administering Officer)

Republic of the Philippines Department of the Interior and Local Government National Police Commission NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING
(Revised Form 2009)

I, _______________________________________________, of legal age, residing at

(Rank) (First Name) (Middle Name) (Last Name)

__________________________ a bonafide member of Philippine National Police, presently assigned at _______________________ designated to the position as __________________
(Office/Unit)

__________________________

effective

on

_________________________________

after

having duly sworn to in accordance with law, do hereby depose and state: That, I am an applicant for promotion to the rank of __________________________; That, my highest educational attainment in a recognized institution of higher learning is
___________________________________________________;
(Baccalaureate/Masters/Doctorate Degree)

That, my highest promotional eligibility is

______________________________________;
(NAPOLCOM Exam/CSC Prof/PO/PD 907/RA 1080)

That, my highest mandatory training is ___________________________________

which I
(Equivalence Accredited by DHRDD)

completed on _______________________________: That, I have pending case (s) hereunder:

CRIMINAL/ Admin Case (s) STATUS OF THE CASE (How many years) CASE NR COMPLAINANT(S ) NATURE OF OFFENSE (S)

That, all documents I have submitted to support my promotion are genuine and authentic and that all the originals are now with me for verification and/or comparison; That, I agree to the automatic nullification of my promotion and I hold myself liable for perjury, falsehood, misrepresentation or omission or act of

dishonesty or for any fraudulent, fake or tampered documents that I have submitted; That, I attest to the truthfulness of this undertaking and submit to the legal and administrative consequences thereof if ever the statements above are wanting in truth and in substance.
______________________________________

Affiant

Community Tax Cert No.______________________________ Dated:____________ Place:___________________________ SUBSCRIBED AND SWORN TO before me this ____ day of _______________, 2009, at ____________________________, Philippines. ___________________________________ (Administering Officer)