DPRM RSD FORM-01-A (REVISED 2019)

Republic of the Philippines

National Police Commission
NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE
Camp BGen Rafael T Crame, Quezon City
AFFIDAVIT OF UNDERTAKING
[LINE OFFICER PRO/NOSU]
I, ______________ _ , of legal age,
(Rank) (First Name) (Middle Name) (Last Name&/Qualifier)

Filipino and presently residing at ____________________________

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

1. This contractual undertaking binds the applicant to strictly comply and abide by
the PNP rules and regulations and corresponding obligations stated therein;

2. That I am a presently assigned at the___________________________________

and designated to the position of ____ ;

3. That I am a lateral entry applicant for line officer this CY 2018 Lateral Entry
Program;

4. That I meet all the Qualification Standards of the position in terms of Education,
Eligibility, Experience, Length of Service in the PNP and Training;
5. That I am willing to be assigned ANYWHERE IN THE PHILIPPINES as my
sworn duty;

6. That I have neither criminal nor administrative cases filed against me;

7. That I will not resign from the service within five (5) years after having taken my
oath of office nor seek reassignment/detail with other PNP units or allied
services outside of until I reach
the rank of Police Senior Inspector; (unit)

8. That should I resign within the five (5) years period, I shall be held liable for civil
indemnity to reimburse the PNP the Initial Clothing Allowance (ICA),
Replacement Clothing Allowance (RCA) and the cost incurred for the recruitment
and trainings undergone, from the date of appointment until resignation; and
9. That I agree to the automatic nullification of my orders and appointment as
Police Inspector and hold myself criminally liable for perjury, falsehood,
misrepresentation or omission of facts, if there is/are an existing pending case/s
against me and/or administratively for acts of dishonesty 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.
FURTHER AFFIANT SAYETH NONE:

(Affiant’s Signature Over Printed Name)

SUBSCRIBED AND SWORN to before me this ___ day of _____ , _______ at
, Philippines, affiant exhibiting his/her CTC No
Issued at on .

NOTARY PUBLIC