CHECKLIST FOR RETIREMENT/SURVIVORSHIP/RESIGNATION

A. RETIREMENT/RESIGNATION/SURVIVORSHIP
1. Duly accomplished Application for retirement
2. Acceptance of resignation
3. Duly accomplished Cash Surrender/Termination Value
4. Application for Terminal Leave
5. Transfer of leave credits from other government (if any)
6. Complete and updated Service Record from other government service, indicating
thereat leave without pay (LWOP), if any. If no LWOP, state NONE and indicating also
the last day of service, duly certified by authorized official
7. Certification from the Office of the City/Provincial Prosecutor of no pending
administrative/criminal case duly certified by authorized official
8. Certification from the Office of the City/Provincial Prosecutor of no money and property
accountability duly certified by authorized official
9. Statements of Assets and Liabilities as of the last day of actual service duly accomplished
and subscribed
10. Department of Justice Clearance
11. Certification of NO PENDING CASE issued by the NPS with filing fee of Php100.00
pursuant to DC No.060 dated 12 October 2012
12. Certification of no books accountabilities with the Department of Justice Library issued
by the Administrative Officer or authorized person delegated by the Provincial/City
Prosecutor
13. Regional State Prosecutor Clearance
14. Certification by the Administrative Officer or duly authorized person delegated by the
Head of Office that the Prosecutor’s Manual/Code of Conduct for Prosecutor/Code of
Conduct for Support Staff have been returned to him/her (if any)
15. Declaration of Pendency/Non Pendency of case, pursuant to RA 10154

B. ADDITIONAL REQUIREMENTS IN CASE OF SURVIVORSHIP/DEATH

16. Duly accomplished application for Survivorship Benefits
17. NSO-original or certified photocopy of Death Certificate of member
18. NSO-original or certified photocopy of Marriage Contract of member
19. NSO-original or certified photocopy of the Birth Certificate of surviving spous if not a
GSIS member
20. NSO-original or certified photocopy of Marriage Contract of parents id the deceased is
single
21. NSO-original or certified Birth certificate of the deceased; if single
22. NSO-original or certified photocopy of birth certificates of all children
23. Affidavit on surviving spouse/claimant stating under oath that he/she is surviving
spouse/immediate surviving legal heirs, that he/she was dependent for support upon
the deceased and that he/she is unmarried at the time of application for survivorship
24. Affidavit that claimant/s is/are the ONLY surviving legal heirs

C. ADDITIONAL REQUIREMENTS FOR PROSECUTORS ONLY (RA 10071)

25. ATM Authorization (ATM Bank Account)

Upon approval of the retirement benefits or survivorship benefits from GSIS, furnished the
Personnel Division a copy of the approved gratuity with voucher, to be used for the
computation of R.A. 10071.