Affidavit of Pensioner

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Republic of the Philippines

NATIONAL POLICE COMMISSION


PHILIPPINE NATIONAL POLICE
PNP RETIREMENT AND BENEFITS ADMINISTRATION SERVICE
Camp BGen Rafael T Crame, Quezon City

AFFIDAVIT OF UNDERTAKING FOR UPDATING

UNDERTAKING

I,_________________________________________________________________________
(FIRST NAME) (MIDDLE NAME) (LAST NAME)
______ y/o, do hereby oblige myself to update the PRBS of my living status within a month before my
(AGE)
birthday every year with the following proof of life: a) By personal appearance at the PRBS or its Satellite
Offices (PRBUs); b) request for visitation if I am physical incapacitated to personally appear for update;
c) By having video call with the PRBS through its Skype Account Address:
[email protected] or E-mail Account Address:[email protected].

The following are my two (2) next of kin/trustee/associates with the contact details:
FIRST NAME MIDDLE NAMELAST NAMERELATIONSHIP CONTACT NUMBER
1. ________________________________________________________________
COMPLETE ADDRESS:
__________________________________________________________________

2. ________________________________________________________________
COMPLETEADDRESS:
__________________________________________________________________

I am fully aware that my monthly pension shall be tagged and subsequently deleted in case I
failed to perform the afore-stated obligation.

_______________________________
PNP Pensioner
SIGNATURE OVER PRINTED NAME

CP No.:______________________
Date :______________________

Note: This affidavit shall not be valid if not notarized.


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PRBS PENSION AND GRATUITY DIVISION


ACKNOWLEDGEMENT STUB

I, ________________________________________________________________________________,
(FIRST NAME) (MIDDLE NAME) (LAST NAME)
appeared at PRBS/PRBU ___ for updating of my living status.

Updated by: __________________________ Date: __________________ Next Update: ______________

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