AFFIDAVIT of Undertaking

1) The document is an affidavit of undertaking that must be signed by applicants for the 2021 1st Cycle Patrolman/Patrolwoman Attrition Recruitment Program. 2) It states that the applicant will not resign within 3 years of taking their oath of office or seek reassignment for 5 years until reaching the rank of Police Corporal. If they do resign within 3 years, they will be liable for expenses incurred by the government in their recruitment and training. 3) It also certifies that the applicant has no pending criminal, civil, or administrative cases and authorizes the PNP to verify their qualifications and records.

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AFFIDAVIT of Undertaking

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Jhessamie Notyalc Autor

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DPRM RSD FORM 2015-01-C

Republic of the Philippines

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

AFFIDAVIT OF UNDERTAKING
[PATROLMAN/PATROLWOMAN]

I, ___________________________________________________, of legal age,

(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:
That I am a Patrolman/Patrolwoman (Pat) applicant for this CY 2021 1st Cycle PAT Attrition
Recruitment Program;
That I was born on _____________;
That I am a graduate of ______________________________ and holder of
(Degree/Course)
____________________ eligibility;
That I have not been dishonourably discharge from military employment or on Absence Without
Official Leave or Dropped from Rolls from the PNP service or dismissed for cause from any uniformed
service in the Government;
That I have no pending criminal/civil/administrative case/s in any court, including at the office of the
Ombudsman;
That I have not been convicted by final judgement of an offense or crime involving moral turpitude;
That I will not resign from the service within three (3) years after having taken my oath of office nor
seek reassignment/detail with other PNP units for the period of five (5) years until I reach the rank of Police
Corporal;
That if I should resign within the three (3) years period I shall be held liable for civil indemnity to
include the total amount incurred by the Government such as recruitment expenses, training expenses,
Initial Clothing Allowance (ICA), salaries and allowances obtained during my mandatory training/specialized
courses while in temporary status;
That I agree to the automatic nullification of my appointment as Patrolman and hold myself liable for
perjury, falsehood, misinterpretation or omission of facts, if there exists a pending case against me and/or
falsification or act of dishonesty for any fraudulent, fake or tampered documents that I have submitted; and
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 declaration if any, in any agency or office.
FURTHER AFFIANT SAYETH NONE:

_________________________
(Affiant’s Signature Over Printed Name)

SUBSCRIBE AND SWORN to before me this ______ day of ___________ 2021 at Cebu City,
Cebu, Philippines, affiant exhibiting his/her CTC No _____________________ Issued at
________________________________ on __________________.

NOTARY PUBLIC
DPRM FORM RSD-01-C
Republic of the Philippines
National Police Commission
NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE
Camp Crame, Quezon City

AFFIDAVIT OF UNDERTAKING

I, ___________________________________________________, of legal age,

(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 that:
1. I am an applicant for this CY 2021 1st Cycle Patrolman/Patrolwoman Attrition Recruitment
Program;

2. I am a graduate of ______________________________
(Degree/Course)
and holder of _________________ eligibility;

3. I was born on _____________ (Month/Day/Year format) as appearing in my Philippine Statistics

Authority issued Birth Certificate and that I am hereby notified that my declared birth date indicated
herein shall become incontestable on so far as my service in the PNP is concerned after the lapse
of six (6) months from the effectivity of my appointment;

4. That in the event I will file a petition to alter or correct entries in my birth records before any court
or the CSC, I hereby undertake to first inform the DPRM (Attn: C, RMD) before filing the same; and

5. That I am aware that any misinterpretation, omission, or misdeclaration of my birth date

committed during the initial recruitment/appointment process, or finding that I entered the service
below the minimum or above the maximum allowable age at the time of my appointment, without
the necessary age waiver shall be a ground for the filing of an administrative case/institution of
termination proceedings for dishonesty, as well as the filing of criminal charges for perjury.

_____________________
Affiant