FORM 1_OUS UNDERTAKING (GRADUATING)

REPUBLIC OF THE PHILIPPINES )

CITY OF MANILA ) S.S.

AFFIDAVIT OF UNDERTAKING

I, Kristine Jane M. Manalastas , of legal age, Filipino, with residence and postal address at 545 Golden Grain Villas, Purok
3, Mojon, City of Malolos, Bulacan after having been duly sworn to in accordance with the law, do hereby depose and say
THAT:

1. I am a graduating student of the Polytechnic University of the Philippines (PUP) Open University System with
the course of BSBA Major in Human Resource Management and Student I.D. No. 2017-09970-MN-0.
In compliance with the requirements of the aforementioned University, I hereby undertake to submit:
Common Documents (all programs):
a) Transcript of Records with remarks “Copy for PUP Open University System”
b) Form 137-a with remarks “Copy for PUP Open University System
c) PSA Birth Certificate (original)
d) PSA Marriage Certificate (original)
e) Local Civil Registry Copy of Birth Certificate
f) Receipts of the following: (1) Graduate program Thesis defense fee, (2) Accomplished General
Clearance, (3) Application for Graduation (4) Graduation, TOR and Certificate fee and (5)
Readmission form and fee
For Graduate Programs
a) Three (3) final hardbound copies of my thesis
b) A soft copy (CD) of thesis: word format, PDF Version, word publication format & PDF publication
format
c) Copyright registration (acknowledgment receipt)
d) Certificate of attendance in paper presentation
e) Others (please specify): _________________________________________.
not later than JULY 30, 2021.

2. I fully understand that compliance of the abovementioned requirements is strictly mandatory and failure to
submit the same shall be a cause for the revocation of my degree and shall prevent the University to release my
school record/s;
3. I likewise undertake and assume full and complete responsibility for all the consequences which may arise due
to the revocation of my degree and the non-issuance of my school records, and;
4. I shall not hold the University liable for not releasing my school records until I have fully complied with the
requirements mentioned above;
5. I am executing this affidavit of undertaking in order for the University to proceed with the processing of my
certificate of candidacy/clearance pending submission of the aforementioned requirements.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of _____________, 201__ at
___________________.

___________________________________
AFFIANT

SUBSCRIBED AND SWORN to before me this ________ day of _____________, 20__ at

____________________, Philippines, affiant exhibiting to me his/her ______________________ as proof of his/her
identity.

NOTARY PUBLIC
Doc. No. __________
Page No. __________
Book No. _________
Series of 20___.
FORM 1_OUS UNDERTAKING (GRADUATING)