Refund Consent Form

CONSENT
I, _________________________, is a registered examinee for the March 15, 2020 Career
Service Examination-Paper and Pen Test in Region 1. In view of the examination cancellation, I
am claiming for the refund of my Examination Fee from the Civil Service Commission Region 1.

For this purpose, I am voluntarily providing said Office my personal bank account/GCash
account and the number where deposit/transfer shall be made.

That I understand that said information shall be used by CSC Region 1 solely for the
purpose of depositing/transferring payment of my refund of examination fees. I understand,
further, that as soon as the indicated purpose has been served, said Office shall destroy,
de-identify, or delete all information subject of this consent.

Signed this _____ day of ____________, 2021, ______________, ________________.

(City/Municipality) (Province)

__________________________
(Name & Signature of Refundee)