CONFIDENTIAL

PHILIPPINE NAVY
HEADQUARTERS PHILIPPINE MARINE CORPS
Fort Bonifacio, Makati City

SUMMARY OF INFORMATION
(As of _____________)

INSTRUCTION:

To fill up the form type or print legibly all items entered.

1. RANK/NAME/AFPSN/BR SVC:
2. SEX 3. MARITAL STATUS :
4. POSTAL ADDRESS/TEL NR:
5. DATE/PLACE OF BIRTH

6. NEXT OF KIN:
DATE OF ADDRESS
7. DEPENDENT RELATIONSHIP BIRTH

8. SKILL: ACTIVE COMSD SVC:

9. LENGTH OF MILITARY ACTIVE SERVICE:

DAY MONTH YEAR

10. PRESENT DUTY ASSIGNMENT:

11. SCHOOLING:

A. CIVILIAN:

COURSE NAME OF PERIOD OF STANDING COMPLETED (Y/N)

TAKEN SCH/LOCATION ATTENDANCE

B. MILITARY:

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COURSE TAKEN NAME OF PERIOD OF STANDING COMPLETED (Y/N)

SCH/LOCATION ATTENDANCE

PREVIOUS ASSIGNMENT:

PRIMARY DUTIES:

POSITION UNIT INCL DATE AUTHORITY

A. ADDITIONAL DUTIES:

12. STATEMENT OF SERVICE:

A. MILITARY SERVICE:

B. PROMOTION/DEMOTION

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C. REMARKS:

13. AWARDS/DECORATIONS AND COMMENDATIONS

A. AWARDS/DECORATION:

TYPE OF AWARDS AUTHORITY

B. COMMENDATIONS:

DATE AWARDED BY

C. APPRECIATION/MERITS:

14. DATE OF COMPULS0RY RETIREMENT: _______________

I CERTIFY THAT THE FOLLOWING ANSWER ARE TRUE AND CORRECT TO THE BEST OF
MY KNOWLEDGE AND BELIEF.

__________________
__________________
TIN NR: ___________

AUTHENTICATED BY:

___________________________

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