Republic of the Philippines

COMMISSION ON AUDIT
Commonwealth Ave., Quezon City

OFFICE OF THE CHAIRPERSON

Internal Affairs Office

Date

REQUEST FOR ISSUANCE

OF CERTIFICATE OF NO PENDING ADMINISTRATIVE CASE

Rossana Victoria F. Ramirez

Name:
First Name Middle Name Surname Ext.

SA 111
Position:
COA - NPC
Office:
Corporate
Sector:
Retirement
Purpose:

In case of Retirement:

0 Mandatory

0x Optional
November 05, 2005
Effectivity Date of Retirement: _ _ _ _ _ _ __

Requesting Party:

Rossana Victoria F. Ramirez

(Signature over printed name)