CS Form No.

4
Series of 2017

Republic of the Philippines

National Police Commission
PHILIPPINE NATIONAL POLICE
POLICE REGIONAL OFFICE 5
Camp BGen Simeon A Ola, Legazpi City

CERTIFICATE OF ASSUMPTION TO DUTY

This is to certify that has

assumed the duties and responsibilities as in
______________________________of effective
__________________________.

This certification is issued in connection with the issuance of the appointment of

____________________________________as in
______________________________

Done this _____ day of _____________________ in _______________________

_____________________________

PBGEN ARNEL B ESCOBAL

Regional Director, PRO5
Head of Office/ Department/ Unit

Date: ________________

Attested by:

PCOL ROQUE A BAUSA

Chief, RPRMD _ ___
Highest Ranking HRMO

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