Professional Documents
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DRRM FORM RSD-03-A (Revised 2014)
DRRM FORM RSD-03-A (Revised 2014)
I, ______________, of legal age, residing at _______, a member of Philippine National Police, presently assigned at
Regional Operations and Plans Division, PRO1 designated to the position of ________ effective on ________________ for
having duly sworn to in accordance with law, do hereby depose and state that:
The following are the details of my pending criminal and/or admin case(s) and records of suspension/demotion from my
present rank:
Case Status Date Filed/Period
Nature of Complainant Case (Pending or Penalty/Decision Penalty Imposed
Complaint/Offens Tittle/Number resolved)
e and Venue
none none none none none none
That I attest to the truthfulness of the forgoing declaration and submit myself to the legal consequences thereof, if ever
the statements above are wanting in truth and in 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
_____________________________
(Notary Public)
Doc. No._________________
Page No._________________
Book No._________________
Series of 2017