Republic of the Philippines

Department of Interior and Local Government

Bureau of Fire Protection
NATIONAL HEADQUARTERS
Agham Road, Brgy. Bagong Pag-asa, Quezon City
Telefax Number: (02) 8426-0246 local 201
rbas.nhq@bfp.gov.ph

CPS FORM 1
RETIREMENT BENEFITS FORM
Retirement Art. II Sec. 8.1, 8.2, 8.3; Art. IV Sec. 12.1 of RSBS
RANK/NAME :
UNIT ASSIGNMENT :
DATE RETIRED :
ADDRESS :
DATE OF BIRTH :
ITEM NUMBER :

RETIREMENT UNDER SEC. 75 R.A. 6975

"Monthly Retirement pay shall be fifty percent (50%) of the base pay and longevity pay of the retired
grade in case of twenty (20) years of active service increasing by two and one-half percent (2.5%) for
every year of active service rendered beyond twenty (20) years to a maximum of ninety percent (90%)
for thirty six (36) years of service and over"

I CREDITABLE YEARS IN SERVICE

YEARS MONTHS DAYS
DATE OF RETIREMENT :
DATE ENTERED SERVICE :
TOTAL CREDITABLE YRS :

II HIGHEST SALARY RECEIVED w/ one (1) rank higher from ________ to _______
w/o one (1) rank higher
BASE PAY : ₱
LONG PAY : [ ]
HIGHEST SALARY RECEIVED : ₱

III COMPUTATION OF TOTAL RATE

1 yrs. X 2.5% = %
2 mos/ 12 x 2.5% = %
3 days/360 x 2.5% = %
TOTAL RATE %

IV MONTHLY PENSION (Total Salary x Total Rate)

₱ x % =₱ /mo.

V THREE YEARS LUMP SUM (Monthly pension x 36 mos.)

₱ x 36 months =₱

Prepared by: Noted by:

Verified by:

BFP-QSF-RBAS-001A Rev.02 (02.01.23)