DOCUMENTARY REQUIREMENTS

FOR PSOCC

PEMS AMANO_DOMINGO JR_R

143693
PARMU-ILOCOS SUR PPO, PRO 1
09958002249/09162877653

DOCUMENTARY REQUIREMENTS
FOR PSOCC

PEMS AMANO_DOMINGO JR_R

143693
PARMU-ILOCOS SUR PPO, PRO 1
09958002249/09162877653
 TABLE OF CONTENTS
A. Endorsement from C, RLDD addressed to RTC 1

B. Recommendation from Unit

C. Certification from Unit re: Passing Result of Qualifying Examination

D. Generated PNP Personal Data Sheet (PAIS)

E. Authenticated Certificate of Completion, Final Order of Merit, Declaration of Graduates

F. Medical Certificate issued by respective RMDU with the following attachments:

> Electrocardiogram (ECG) Result

> Hepa-B Test Result
> Chest X-ray Test Result
> Urinalysis, CBC, Blood Chemistry
> Drug Test Result (w/negative Result)
> Nuero Psychiatric Result (w/”Recommended” Remarks)
> BMI Monitoring Chart (duly certified by respective Health Unit)

G. Photocopy of Vaccination and Booster Card

H. Certificate of Non-Pending Case (Legal/RIAS)

I. Affidavit of Undertaking relative to the truthfulness of submitted documents

J. Latest Two (2) 2X2 ID picture with name tag

 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 1
ILOCOS SUR POLICE PROVINCIAL OFFICE
Camp President Elpidio R Quirino, Bulag, Bantay, Ilocos Sur

Affidavit of Undertaking

I, PEMS Domingo Raquel Amano, Jr, Filipino, of legal age, assigned at

Provincial Administrative Resource Management Unit, having been subscribed to an
oath, depose say:

1. That I am applying for schooling on Public Safety Officers Candidate Course

(PSOCC) which will be conducted and facilitated by the Regional Training
Center 1, Aringay, La Union;

2. That I attest to the truthfulness of my documents and submit myself to the legal
consequences thereof, if ever the statements above are wanting in truth and in
substance.

PEMS Domingo R Amano, Jr

Affiant

SUBSCRIBED AND SWORN TO before me this _____ of June 2023 at Camp Pres
Elpidio R Quirino, Bulag, Bantay, Ilocos Sur, Philippines.

PLTCOL REYNALDO C MENDOZA, JR

Chief, PARMU_____________________
Administering Officer
 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 1
ILOCOS SUR POLICE PROVINCIAL OFFICE
Camp President Elpidio R Quirino, Bulag, Bantay, Ilocos Sur

Affidavit of Undertaking

I, PEMS Chester G Dandin, Filipino, of legal age, assigned at Vigan City Police
Station, having been subscribed to an oath, depose say:

1. That I am applying for schooling on Public Safety Officers Candidate Course

(PSOCC) which will be conducted and facilitated by the Regional Training
Center 1, Aringay, La Union;

2. That I attest to the truthfulness of my documents and submit myself to the legal
consequences thereof, if ever the statements above are wanting in truth and in
substance.

PEMS Chester G Dandin

Affiant

SUBSCRIBED AND SWORN TO before me this _____ of June 2023 at Camp Pres
Elpidio R Quirino, Bulag, Bantay, Ilocos Sur, Philippines.

PLTCOL REYNALDO C MENDOZA, JR

Chief, PARMU_____________________
Administering Officer
 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 1
ILOCOS SUR POLICE PROVINCIAL OFFICE
Camp President Elpidio R Quirino, Bulag, Bantay, Ilocos Sur

Affidavit of Undertaking

I, PEMS Victorino Harold G Baquirin, Filipino, of legal age, assigned at PARMU-

GSO, having been subscribed to an oath, depose say:

3. That I am applying for schooling on Public Safety Officers Candidate Course

(PSOCC) which will be conducted and facilitated by the Regional Training
Center 1, Aringay, La Union;

4. That I attest to the truthfulness of my documents and submit myself to the legal
consequences thereof, if ever the statements above are wanting in truth and in
substance.

PEMS Victorino Harold G Baquirin

Affiant

SUBSCRIBED AND SWORN TO before me this _____ of June 2023 at Camp Pres
Elpidio R Quirino, Bulag, Bantay, Ilocos Sur, Philippines.

PLTCOL REYNALDO C MENDOZA, JR

Chief, PARMU_____________________
Administering Officer
 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 1
ILOCOS SUR POLICE PROVINCIAL OFFICE
Camp President Elpidio R Quirino, Bulag, Bantay, Ilocos Sur

Affidavit of Undertaking

I, PSSg Glenn Ford V Rilveria, Filipino, of legal age, assigned at PARMU-GSO,

having been subscribed to an oath, depose say:

1. That I am applying for schooling on Public Safety Junior Leadership Course

(PSJLC) which will be conducted and facilitated by the Regional Training Center
1, Aringay, La Union;

2. That I attest to the truthfulness of my documents and submit myself to the legal
consequences thereof, if ever the statements above are wanting in truth and in
substance.

PSSg Glenn Ford V Rilveria

Affiant

SUBSCRIBED AND SWORN TO before me this _____ of June 2023 at Camp Pres
Elpidio R Quirino, Bulag, Bantay, Ilocos Sur, Philippines.

PLTCOL REYNALDO C MENDOZA, JR

Chief, PARMU_____________________
Administering Officer