DPRf RSD FORN 20 J 0J C

Republic of the Philippines

National Police Commission
NATIONAL HEADQUARTERS, PHILIPPINE NATIONAL POLICE
Coup Crame. Quezon @fy

AFFIDAVIT OF UNDERTAKING
(Incontestabiliy of Declared Birth Date)

I r- ms Camo y (Mtddie Ham e} {Last Hama) \Q ualldler}

presently residing at y. \‹ - i '' *. ,. °› ’.‘’* ’i .*- ’ ’-*• ‘ - ’- " '“ ’
after having, been duly sworn to in accordance with law, do hereby repose and state that.

1. I am an applicant for this CY 2020 PATROLMAN Regular Recruitment program;

2
[Degree/Course)
and holder of eligibility;

3. I was born on I.' ’“.'8 . (Month/Day/Year format) as appeanng in my PSA BIRTH

CERTIFICATE (Proof ot Birth e.g. NSO issued Birth Certificate/Local Registry Birth
Certificate), and that I am hereby notified that my decia ed birth date indicated herein shal.
become incontestable in so far as my service in the PNP is concerned after the lapse of six
(6) months from the effectivity of my appointment;

That in the event hat I will file a petition to alter or correct entries in my birth records
before any court or ihe CSC. I hereby undertake to first inform the DPRIVI (Attn: C,
RMD) before filing the same, and

5. That am aware that any misrepresentation, omission, or misdeclaration of my birth date

committed during the initial recruitment/appointment process, or finding that I entered the
service below the minimum or above the maximum allowable age at the time of my
appointment, without the necessary age waiver shall be a ground for the filing of an
administrative case/institution of termination proceedings for dishonesty. as applicable, as
well as the filing of criminal charges for perjury.

SUBSCRIBED AND SWORN TO before me this day of — ” ** , 20 , at

, Philippines.

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