Affidavit of Undertaking

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DPRM FORMRSD-03-A(Revised 2017)

Republic of the Philippines


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

AFFIDAVIT OF UNDERTAKING FOR PROMOTION

I, PSMS Jose Gimena Baldicasa Jr , of legal age, residing at


(Rank) (First Name) (Middle Name) (Last Name)
Sitio Polo, Brgy., Baliwagan, Balamban, Cebu , a member of Philippine National Police
presently assigned at SOCO CPPO/ RCLO7 designated to the position of SOCO Team Leader
(Office/Unit)
effective on November 2, 2020 after having duly sworn to in accordance with law, do hereby
depose and state that:
1. I am a candidate for promotion to the rank of Police Chief Master Sergeant
;
2. I possess all the mandatory qualifications (i.e. eligibility, training, time-in-grade and
education) and other collateral requirements for promotion;
3. All the documents I have submitted to support my promotion are accurate, genuine and
authentic and that all the originals are now with me ready for verification and/or
comparison anytime;
4. I passed the E-Learning Program as required under PNP P.A.T.R.O.L. Plan 2030;
5. I will not seek reassignment and/or detail to other offices/units within six months from
the issuance of my promotion order;
6. I am fully aware of my liability and responsibility in the foregoing declaration under the
law and regulation of the PNP, NAPOLCOM and CSC;
7. I agree to the AUTOMATIC NULLIFICATION of my promotion and I hold myself
administratively and criminally liable for “DISHONESTY” and “PERJURY” for falsehood,
misrepresentation or omission and for any fraudulent, falsification or tampered
documents that I have submitted;
8. I have read and checked all entries appearing in my attached Personnel Accounting and
Information System (PAIS) Generated PDS and that I certify that all entries thereof are
true and correct;
9. 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 this declaration if any, in any agency or office.
10. Since the pendency of my appeal/grievance/complaints for promotion renders this
application moot and academic, I hereby voluntarily withdraws said appeal/grievance/
complaints for purposes of promotion;
11. I have criminal and/or administrative case; YES NO
I was suspended from my present rank; YES NO
I was demotedfrom my present rank; and YES NO
An appeal is pending, in lieu thereof, before any judicial
and administrative or quasi judicial bodies. YES NO

12. I have attached the certification from the court and quasi-judicial body on the status of
the case, if applicable. YES N/A
*Continuation at the back page
The following are the details of my pending criminal and/or admin case(s) and records of
suspension/demotion from my present rank: (If there’s none, put N/A on each column)
CASE CASE STATUS
NATURE OF COMPLAINT/ PENALTY/ DATE FILED/
COMPLAINANT TITLE/NUMBER (Pending or
OFFENSE DECISION PERIOD PENALTY IMPOSED
AND VENUE Resolved)
N/A N/A N/A N/A N/A N/A

NOTE: Use extra sheet if necessary

That I attest to the truthfulness of the foregoing declaration and submit myself to the
legal consequences thereof, if ever the statements above are wanting in truth and in
substance. Affiant declares that he/she has read and understood the affidavit of undertaking
and that the same is his/her act and deed.

______________________________________
Affiant
SUBSCRIBED AND SWORN TO before me this ____ day of _______________, 21___, at
____________________________, Philippines.

___________________________
(Notary Public)
Doc. No._____________
Page No. ____________
Book No. ____________
Series of 2017

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