CSCNCR-DOSTFO Checklist Form 1

Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name

Position Title/Rank SG/Step: Date of Birth:

Annual Place of Birth:

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P
3. Training P
4. Eligibility P
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P
b. Nature of Appointment P
c. Signature of Appointing Authority P
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common
Requirements 6. Updated Personal Data Sheet (Item V-F & A) P
(CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion, transfer,
reappointment (change of status to P
permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment (CS P

Form No. 3, Rev. 2017)

12.With Decided Administrative/Criminal Case

(Resolution/Decision) CTC of Decision issued P
(Office, court/tribunal)
13.With pending criminal case pursuant to
Command MC No. 10=2015 dated May 6, P
Additional
Requirements in 2015
Specific Case
14. Discrepancy in Name, Date/Place of Birth
as appearing in the Report of Rating or COE, P
appointment, service card and the entries in
the PDS
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Major SG/Step: 24 Date of Birth: January 1, 1975

Annual 750,660.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Captain SG/Step: 23 Date of Birth: January 1, 1975

Annual 678,984.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Lieutenant SG/Step: 22 Date of Birth: January 1, 1975

Annual 594,336.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Executive Master Sergeant SG/Step: 19 Date of Birth: January 1, 1975

Annual 460,392.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Chief Master Sergeant SG/Step: 18 Date of Birth: January 1, 1977

Annual 417,132.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PBGEN VICENTE DUPA DANAO, JR
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Senior Master Sergeant SG/Step: 17 Date of Birth: January 1, 1979

Annual 408,948.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Master Sergeant SG/Step: 16 Date of Birth: January 1, 1983

Annual 400,932.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
Requirements in 13.With pending criminal case pursuant to P
14. Discrepancy
Command in Name,
MC No. Date/Place
10=2015 dated Mayof6,
Specific Case Birth
2015 as appearing in the Report of Rating
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Police Staff Sergeant SG/Step: 14 Date of Birth: January 1, 1987

Annual 385,368.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Promotion
c. Signature of Appointing Authority P PBGEN VICENTE DUPA DANAO, JR
d. Date of Signing P
e. Certification of publication P
f. Certification of PSB Chairperson P
g. Appointee's Signature at P
Acknowledgement/Date
Common 6. Updated Personal Data Sheet (Item V-F & P
Requirements A) (CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion,
transfer, reappointment (change of status P
to permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment P

(CS Form No. 3, Rev. 2017)
12.With Decided Administrative/Criminal
Case (Resolution/Decision) CTC of Decision P
issued (Office, court/tribunal)

Additional
13.With pendingincriminal P
Requirements in 14. Discrepancy Name, case pursuant
Date/Place of to
Specific Case Command MC No. 10=2015 dated May 6,
Birth as appearing in the Report of Rating
2015
or COE, appointment, service card and the
entries in the PDS P
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)
First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Jerson Arrabis Navarro N/A

Position Title/Rank Police Staff Sergeant SG/Step: 14 Date of Birth: March 28, 1988

Annual
385,368.00 Place of Birth: Camarines Sur
Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree BS Criminology
Qualification with Master's Degree
Standards 2. Time-In-Grade (Experience) 2 years
3. Training With required training
4. Eligibility RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original
copies
a. Employment Status Permanent
b. Nature of Appointment Promotion
c. Signature of Appointing Authority PBGEN VICENTE DUPA DANAO, JR
d. Date of Signing
e. Certification of publication
f. Certification of PSB Chairperson
g. Appointee's Signature at
Acknowledgement/Date
Common
Requirements 6. Updated Personal Data Sheet (Item V-F & A)
(CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion, transfer,
reappointment (change of status to
permanent) or reemployment

8. Position Description Form (PDF)

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018)
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018)

11 Erasures or Alterations on Appointment (CS

Form No. 3, Rev. 2017)

12.With Decided Administrative/Criminal Case

(Resolution/Decision) CTC of Decision issued
(Office, court/tribunal)
13.With pending criminal case pursuant to
Additional Command MC No. 10=2015 dated May 6,
Requirements in 2015
Specific Case
14. Discrepancy in Name, Date/Place of Birth
as appearing in the Report of Rating or COE,
appointment, service card and the entries in
the PDS
15.Change of Civil Status
16.COMELEC Ban
17. Others:
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:
Margarita G. Reyes
Director II Date
CSC NCR-DOST Field Office
CSCNCR-DOSTFO Checklist Form 1
Revised 08.04.2020

ATTESTATION PROCESS CHECKLIST

For Uniformed Personnel(Original Appointment/Regular Promotion)

First Name Middle Name Surname Extension Name (e.g. Jr., Sr.)
Name
Juan Santos Cruz
N/A
Position Title/Rank Patrolman SG/Step: 10 Date of Birth: January 1, 1990

Annual 356,016.00 Place of Birth: Tondo, Manila

Compensation
Agency Philippine National Police Sector: NGA Accredited/Deregulated)
Regulated

Criteria Yes No Remarks

1. Education: Bachelor's Degree P BS Criminology
Qualification with Master's Degree P
Standards 2. Time-In-Grade (Experience) P 3 years
3. Training P With required training
4. Eligibility P RA 6506
5. CS Form No. 33-A, Rev. 2018, 3 original P
copies
a. Employment Status P Permanent
b. Nature of Appointment P Reappointment
c. Signature of Appointing Authority P PMGEN DEBOLD M SINAS
d. Date of Signing P November 30, 2020
e. Certification of publication P
f. Certification of PSB Chairperson P PBGEN NOLASCO K BATHAN
g. Appointee's Signature at P
Acknowledgement/Date
Common
Requirements 6. Updated Personal Data Sheet (Item V-F & A) P
(CS Form No. 212, Rev. 2017)
7. Original copy of the authenticated
Certificate of Eligibility (COE)/rating/license
for original appointment, promotion, transfer,
reappointment (change of status to P
permanent) or reemployment

8. Position Description Form (PDF) P

DBM-CSC Form No. 1 (Rev. Ver. 1, s. 2017)
9.Oath of Office (CS Form No. 32, Rev. 2018) P
10.Certificate of Assumption to Duty (CS
Form No. 4, Rev. 2018) P

11 Erasures or Alterations on Appointment (CS P

Form No. 3, Rev. 2017)

12.With Decided Administrative/Criminal Case

(Resolution/Decision) CTC of Decision issued P
(Office, court/tribunal)
13.With pending criminal case pursuant to
Command MC No. 10=2015 dated May 6, P
Additional
Requirements in 2015
Specific Case
14. Discrepancy in Name, Date/Place of Birth
as appearing in the Report of Rating or COE, P
appointment, service card and the entries in
the PDS
15.Change of Civil Status P
16.COMELEC Ban P
17. Others: P
FOR CSCNCR - DOST FO ACTION:
APPROVED Notation:
DISAPPROVED Ground:
Evaluated by: Date
Final Action by:

Date