RSD DPRM FORM 2014-1B

Republic of the Philippines

National Police Commission
NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

AFFIDAVIT OF UNDERTAKING
[POLICE OFFICER 1 PSF QUOTA APPLICANT]

I, ____________________________________________, of legal age, Filipino

(First Name) (Middle Name) (Last Name/Qualifier)
and presently residing at __________________________________________________
after having duly sworn to in accordance with law, do hereby depose and state:
1. That I am a Police Officer 1 (PO1) applicant for this CY ___________ Regular
Recruitment Program of __________________________________________________;
(Unit Office)
2. That I was born on ______________________;
3. That I am a graduate of ________________________________________ and
(Degree Course)
holder of ______________________________________________________________
eligibility;
4. That I have not been dishonourably discharged from military employment or on
Absence without Official Leave or Dropped from Rolls from PNP service or dismissed for
cause from any civilian position in the Government;
5. That I have no pending criminal case in any court, including at the office of the
Ombudsman or administrative case;
6. That I have not been convicted by final judgment of an offense or crime involving
moral turpitude;
7. That I agree to the automatic nullification of my appointment as Police Officer
1 and hold myself liable for perjury, falsehood, misrepresentation or omission of facts, if
there exist a pending case against me and/or falsification or act of dishonesty for any
fraudulent, fake or tampered documents that I have submitted;
8. That I will not resign from the service within (3) years after having taken my oath
of office nor seek reassignment/detail with other PNP units or allied services outside of
___________________________ for at least five (5) years;
(Unit)
9. That I further certify that the foregoing declarations are true and accurate to the
best of my knowledge and ability and I hereby authorized the PNP to obtain and secure
pertinent records that will show my qualification standards, collateral requirements and
case records and other record related to these declarations if any, in any agency or office.

FURTHER AFFIANT SAYETH NONE:

________________________________
(Affiant’s Signature Over Printed Name)

SUBSCRIBED AND SWORN to before me this ______ day of _________, 201__

at _______________________________, Philippines, affiant exhibiting his/her CTC No.
__________________ issued at ___________________ on ____________________.

NOTARY PUBLIC