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

I, ____________________________________________________, of legal age,

Filipino, (First Name) (Middle Name) (Last Name) (Qualifier)

presently residing at _________________________________________________after

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

1. I am an applicant for this CY_______PO1/Lateral Entry Program (Line/Technical

Officers) 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 ______________________(Proof of Birth e.g. NSO issued Birth
Certificate/Local Registry Birth Certificate), and that I am hereby notified that my
declared birth date indicated herein shall become incontestable in 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 that 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 misrepresentation, 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 applicable, as well as the filing of criminal charges for perjury.

_____________________________
Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of _______________,

20___, at ____________________________, Philippines.

________________________
(Notary Public)

Doc:________
Page:_______
Book:________
Series of ______