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Affidavit of Undertaking-2

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Republic of the Philippines Department of the Interior and Local Government National Police Commission NATIONAL HEADQUARTERS, PHILIPPINE

NATIONAL POLICE Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING
(Revised Form 200 !

I" ###############################################" of le$al a$e" residin$ at


(Ran%! (First Name! (&iddle Name! (Last Name!

########################## a bonafide member of Philippine National Police" presentl' assi$ned at ####################### desi$nated to the position as ##################
((ffice)*nit!

########################## effective on ################################# after

havin$ dul' s+orn to in accordance +ith la+" do hereb' depose and state, -hat" I am an applicant for promotion to the ran% of ##########################. -hat" m' hi$hest educational attainment in a reco$ni/ed institution of hi$her learnin$ is
###################################################.
(0accalaureate)&asters)Doctorate De$ree!

-hat" m' hi$hest promotional eli$ibilit' is ######################################.


(N1P(LC(& 23am)C4C Prof)P()PD 05)R1 6070!

-hat" m' hi$hest mandator' trainin$ is ################################### +hich I


(28uivalence 1ccredited b' D9RDD!

completed on ###############################, -hat" all documents I have submitted to support m' promotion are $enuine and authentic and that all the ori$inals are no+ +ith me for verification and)or comparison. -hat" I have no pendin$ criminal nor administrative case or an' other claim filed a$ainst me as of this date in an' court" tribunal or 8uasi:;udicial a$enc' and there is no complaint proffered a$ainst me before the (mbudsman or the PL20. -hat" if I should therafter learn that a criminal or administrative case has ben filed or pendin$" or that a complaint +as proffered a$ainst me before the (mbudsman or the PL20" I shall report the fact +ithin five (<! da's from %no+led$e to the Promotion 0oard throu$h the 4ecretariat the complete statement of the present status of the case. -hat" I a$ree to the automatic nullification of m' promotion and I hold m'self liable for per;ur'" falsehood" misrepresentation or omission or act of dishonest', a= If it +ould be discovered later on that a criminal or an administrative case +as filed or is pendin$ or" that a complaint +as proffered a$ainst me before the (mbudsman or the PL20 and there +as failure on m' part to immediatel' inform the 0oard of the same. b= (r for an' fraudulent" fa%e or tampered documents that I have submitted. -hat" I attest to the truthfulness of this underta%in$ and submit to the le$al and administrative conse8uences thereof if ever the statements above are +antin$ in truth and in substance=
######################################

Affiant
Communit' No=############################## Dated,############ Place,########################### -a3 Cert

4*04CRI02D 1ND 4>(RN -( before me this #### da' of ###############" 200 " at ############################" Philippines= ################################### (1dministerin$ (fficer!

Republic of the Philippines Department of the Interior and Local Government National Police Commission NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE Camp Crame, Quezon City

AFFIDAVIT of UNDERTAKING
(Revised Form 200 !

I" ###############################################" of le$al a$e" residin$ at


(Ran%! (First Name! (&iddle Name! (Last Name!

########################## a bonafide member of Philippine National Police" presentl' assi$ned at ####################### desi$nated to the position as ##################
((ffice)*nit!

########################## effective on ################################# after

havin$ dul' s+orn to in accordance +ith la+" do hereb' depose and state, -hat" I am an applicant for promotion to the ran% of ##########################. -hat" m' hi$hest educational attainment in a reco$ni/ed institution of hi$her learnin$ is
###################################################.
(0accalaureate)&asters)Doctorate De$ree!

-hat" m' hi$hest promotional eli$ibilit' is ######################################.


(N1P(LC(& 23am)C4C Prof)P()PD 05)R1 6070!

-hat" m' hi$hest mandator' trainin$ is ################################### +hich I


(28uivalence 1ccredited b' D9RDD!

completed on ###############################, -hat" I have pendin$ case (s! hereunder,


CRIMINAL/ Admin Cas !s" STATUS O# THE CASE !Ho$ man% % a&s" CASE NR COMPLAINANT!S" NATURE O# O##ENSE !S"

-hat" all documents I have submitted to support m' promotion are $enuine and authentic and that all the ori$inals are no+ +ith me for verification and)or comparison. -hat" I a$ree to the automatic nullification of m' promotion and I hold m'self liable for per;ur'" falsehood" misrepresentation or omission or act of dishonest' or for an' fraudulent" fa%e or tampered documents that I have submitted. -hat" I attest to the truthfulness of this underta%in$ and submit to the le$al and administrative conse8uences thereof if ever the statements above are +antin$ in truth and in substance=
######################################

Affiant
Communit' No=############################## Dated,############ Place,########################### -a3 Cert

4*04CRI02D 1ND 4>(RN -( before me this #### da' of ###############" 200 " at ############################" Philippines= ################################### (1dministerin$ (fficer!

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