CS Form No.

4
Series of 2017

Republic of the Philippines

Philippine National Police

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that. ________________________ has assumed the

duties and responsibilities as ___________________ of
_____________________ effective ____________________.

This certification is issued in connection with the issuance of the

promotional appointment of _____________________ as
_________________
Done this ___day of ________________in ________________.

_________________________
Head of Office/Department/Unit

Date: ___________________

Attested by:

____________________
Highest Ranking HRMO

201 file
Admin
COA
CSC For submission to CSCFO
within 30 days from the
date of assumption of the
appointee