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