CS Form No.

4
Series of 2018

Republic of the Philippines

NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
1st st
1 Eastern Samar Provincial Mobile Force Company
Brgy. 15/Lunang, Dolores, Eastern Samar

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms/Mr. Edward Dulfo Baldos has assumed the duties
and responsibilities as Police Corporal of 1st Eastern Samar Provincial Mobile
Force Company, Eastern Samar PPO effective ..

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

of Ms/Mr Baldos as Police Corporal .

Done this day of in Brgy. 15/Lunang,

Dolores, Eastern Samar.

PLTCOL JOSE ROY M TORRECHILLA

Force Commander, 1ESPMFC

Date: ________________

Attested by:

PCOL ANDRE P DIZON

Chief, Regional Personnel and
Records Management Division

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