Republic of the PhilippinesDepartment of the Interior and Local Government

National Police CommissionNATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE

Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING(Revised Form 2009)

I, _______________________________________________, of legal age, residing at (Rank) (First Name) (Middle Name) (Last Name)

__________________________ a bonafide member of Philippine National Police, presently

assigned at _______________________ designated to the position as __________________

(Office/Unit)

__________________________ effective on _________________________________ after

having duly sworn to in accordance with law, do hereby depose and state:

That, I am an applicant for promotion to the rank of

__________________________;

That, my highest educational attainment in a recognized institution of higher learning is ___________________________________________________; (Baccalaureate/Masters/Doctorate Degree)

That, my highest promotional eligibility is ______________________________________;

(NAPOLCOM Exam/CSC Prof/PO/PD 907/RA 1080)

That, my highest mandatory training is ___________________________________ which I

(Equivalence Accredited by DHRDD)

completed on _______________________________:

That, all documents I have submitted to support my promotion are genuine and authentic and that all the originals are now with me for verification and/or comparison;

That, I have no pending criminal nor administrative case or any other claim filed against me as of this date in any court, tribunal or quasi-judicial agency and there is no complaint proffered against me before the Ombudsman or the PLEB;

That, if I should therafter learn that a criminal or administrative case has ben filed or pending, or that a complaint was proffered against me before the Ombudsman or the PLEB, I shall report the fact within five (5) days from knowledge to the Promotion Board through the Secretariat the complete statement of the present status of the case;

That, I agree to the automatic nullification of my promotion and I hold myself liable for perjury, falsehood, misrepresentation or omission or act of dishonesty:

a. If it would be discovered later on that a criminal or an administrative case was filed or is pending or, that a complaint was proffered against me before the Ombudsman or the PLEB and there was failure on my part to immediately inform the Board of the same;b. Or for any fraudulent, fake or tampered documents that I have submitted;

That, I attest to the truthfulness of this undertaking and submit to the legal and administrative consequences thereof if ever the statements above are wanting in truth and in substance.

______________________________________ Affiant

Community Tax Cert No.______________________________Dated:____________ Place:___________________________

SUBSCRIBED AND SWORN TO before me this ____ day of _______________, 2009, at ____________________________, Philippines.

___________________________________ (Administering Officer)

Republic of the PhilippinesDepartment of the Interior and Local Government

National Police CommissionNATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE

Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING(Revised Form 2009)

I, _______________________________________________, of legal age, residing at (Rank) (First Name) (Middle Name) (Last Name)

__________________________ a bonafide member of Philippine National Police, presently

assigned at _______________________ designated to the position as __________________

(Office/Unit)

__________________________ effective on _________________________________ after

having duly sworn to in accordance with law, do hereby depose and state:

That, I am an applicant for promotion to the rank of

__________________________;

That, my highest educational attainment in a recognized institution of higher learning is ___________________________________________________; (Baccalaureate/Masters/Doctorate Degree)

That, my highest promotional eligibility is ______________________________________;

(NAPOLCOM Exam/CSC Prof/PO/PD 907/RA 1080)

That, my highest mandatory training is ___________________________________ which I

(Equivalence Accredited by DHRDD)

completed on _______________________________:

That, I have pending case (s) hereunder:

CRIMINAL/Admin Case

(s)

STATUS OF THE CASE

(How many years)

CASE NR COMPLAINANT(S)

NATURE OF OFFENSE (S)

That, all documents I have submitted to support my promotion are genuine and authentic and that all the originals are now with me for verification and/or comparison;

That, I agree to the automatic nullification of my promotion and I hold myself liable for perjury, falsehood, misrepresentation or omission or act of

dishonesty or for any fraudulent, fake or tampered documents that I have submitted;

That, I attest to the truthfulness of this undertaking and submit to the legal and administrative consequences thereof if ever the statements above are wanting in truth and in substance.

______________________________________ Affiant

Community Tax Cert No.______________________________Dated:____________ Place:___________________________

SUBSCRIBED AND SWORN TO before me this ____ day of _______________, 2009, at ____________________________, Philippines.

___________________________________ (Administering Officer)