DPRM FORM RSD-03-A (Revised 2017)

Republic of the Philippines

National Police Commission
NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

AFFIDAVIT OF UNDERTAKING FOR PROMOTION

I, ________________________________________, of legal age, residing at

(Rank) (First Name) (Middle Name) (Surname)
____________________________________, a member of Philippine National Police, presently
assigned at _________________________________ designated to the position
___________________________________________effective on __________________after
(Office/Unit)
having duly sworn to in accordance with law, do hereby depose and state that:

1. I am a candidate for promotion to the rank of _____________________________________;

2. I posses all the mandatory qualifications (e.i. eligibility, training, time-in-grade and education) and
other collateral requirements for promotion;

3. All the documents I have submitted to support my promotion are accurate, genuine and authentic
and that all the originals are now with me ready for verification and/or comparison anytime;

4. I have passed the E-Learning Program as required under PNP P.A.T.R.O.L. Plan 2030;

5. I will not seek reassignment and/or detail to other offices/units within six months from the issuance of
my promotion order;

6. I am fully aware of my liability and responsibility in the foregoing declaration under the law and
regulation of the PNP, NAPOLCOM and CSC;

7. I agree to the AUTOMATIC NULLIFICATION of my promotion and I hold myself administratively and
criminally liable for “DISHONESTY” and “PERJURY” for falsehood, misrepresentation or omission
and for any fraudulent, falsification or tampered documents that I have submitted;

8. I have read and checked all entries appearing in my attached Personal Accounting and Information
System (PAIS) Generated PDS and that I certify that all entries thereof are true and correct;

9. I further certify that the foregoing declarations are true and accurate to the best of my knowledge and
ability and hereby authorized the PNP to obtain the secure pertinent records that will show my
qualification standards, collateral requirements and case records and other record related to this
declaration if any, in any agency or office;

10. Since the pendency of my appeal/grievance/complaints for promotion renders this application moot
and academic, I hereby voluntarily withdraws said appeal/grievance/complaints for purposes of
promotion;

11. have criminal and/or administrative case; YES NO

I was suspended from my present rank; YES NO
I was demoted from my present rank; and YES NO
An appeal is pending, in lieu thereof, before any judicial
And administrative or quasi judicial bodies. YES NO

12. I have attached the certification from the court and quasi-judicial body on the status of the case, if
applicable, YES NO
 The following are the details of my pending criminal and/or admin case (s) and
records of suspension/demotion from my present rank: (If there’s none, put N/A on each
column)

CASE DATE FILED/

NATURE OF CASE
STATUS PENALTY/ PERIOD
COMPLAINT/ COMPLAINANT TITLE/NUMBER
(Pending or DECISION PENALTY
OFFENSE AND VENUE
Resolved) IMPOSED

NOTE: Use extra sheet if necessary

That I attest to the truthfulness of the foregoing declaration and submit myself to the
legal consequences thereof, if ever the statements above are wanting in truth and substance.
Affiant declares that he/she has read and understood the affidavit of undertaking and that the
same is his/her act and deed.

____________________________
Affiant

SUBSCRIBED AND SWORN TO before me this ______ day of _____________,

20___, at ___________________________________, Philippines.

_____________________________
(Notary Public)

Doc. No.
Page No.
Book No.
Series of 2019