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    Retireecompulsory 1

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    brian grass
    This document is an update and ID application form for retirees receiving a pension. It collects personal information such as name, date of birth, address, rank, retirement details, pension payment information, and emergency contact. The form notes that all fields must be filled out to submit the form, which is part of an inventory of pensioners nationwide. It collects signatures to certify the truthfulness of the information provided and states false information could result in prosecution.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Retireecompulsory 1

    Uploaded by

    brian grass
    216 views1 page
    This document is an update and ID application form for retirees receiving a pension. It collects personal information such as name, date of birth, address, rank, retirement details, pension payment information, and emergency contact. The form notes that all fields must be filled out to submit the form, which is part of an inventory of pensioners nationwide. It collects signatures to certify the truthfulness of the information provided and states false information could result in prosecution.

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    pnp form

    Original Title

    retireecompulsory-1

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    This document is an update and ID application form for retirees receiving a pension. It collects personal information such as name, date of birth, address, rank, retirement details, pension payment information, and emergency contact. The form notes that all fields must be filled out to submit the form, which is part of an inventory of pensioners nationwide. It collects signatures to certify the truthfulness of the information provided and states false information could result in prosecution.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    216 views1 page

    Retireecompulsory 1

    Uploaded by

    brian grass
    This document is an update and ID application form for retirees receiving a pension. It collects personal information such as name, date of birth, address, rank, retirement details, pension payment information, and emergency contact. The form notes that all fields must be filled out to submit the form, which is part of an inventory of pensioners nationwide. It collects signatures to certify the truthfulness of the information provided and states false information could result in prosecution.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    UPDATE and ID APPLICATION FORM

    PNP RETIREE
    ( compulsory )
    Note:This form is deemed not submitted if some spaces are not filled up.
    Put N/A as the case may be. Non-submission will hold the release of
    the subsequent regular pension. This is for the conduct of inventory
    of pensioners nationwide.
    1. Principal Pensioner Personal Data:
    LAST NAME FIRST NAME MIDDLE NAME QUALIFIER

    2. Pensioner’s 3. Date of Birth (Mo, Day, Year) 4. Age 5. Postal (ZIP) Code 6. Telephone No. (Indicate Area Code)
    Rank
    (House No, Street, Municipality, Province)
    7. Address:
    8. Religion 9. Civil Status (Check box) 10. Citizenship 11. Sex (Check box)
    Single Widower Male
    Married Separated Female
    12.Weight: ( kg ) 13. Height (cm) 14. Blood Type

    15. Color of Eyes 16. Color of Hair 17. Other Identifying Marks
    18. Date entered service 19. Date Retired 20. Mode of retirement (Check box)
    Compulsory Retirement TPPD
    Optional Retirement Others (specify) ___________
    21. Retirement Authority (General Orders No. and Date): ________________________________________________
    22. Are you receiving monthly 23. If yes, how much is 24. How do you receive your pension? (Check Box)
    pension? the present amount? Local Pick-up RFSO Authorized Rep
    Yes No P__________________ Thru Banks (indicate name of bank)__________
    25. If yes, since when? ___________ ___________________________________________
    26. Have you allotted part of your pension to another? Yes No
    If yes, state the name of the allottee/ guardian/ common-law-wife and reason for allotment
    (Last Name, First Name, Middle Name, Qualifier) Address Relationship Reason

    27. Person to be notified in case of emergency: Name Relationship

    28. Are you also receiving pension from: GSIS Yes No NAPOLCOM Yes No
    AFP Yes No Others ____________________________
    BENEFICIARY/IES DATA (order of precedence)
    I. Spouse legally married to the retiree while still in the service; legitimate, legitimated, legally adopted, illegitimate children
    born while in the active service
    II. Parents
    29. Names of beneficiaries Address Date of Civil Relationship
    (Last Name, First Name, Middle Name, Qualifier) Birth Status

    I certify that the information herein are true and correct to the best of my knowledge. I have affixed my signature
    and/or thumbmark to attest to its truthfulness and correctness; thereby, I may be held liable for prosecution on any
    misrepresentation hereof.
    Left Right

    ___________________
    Signature of Pensioner Date Signed

    DO NOT FILL-UP THE BOX BELOW:


    Verified By: Reviewed By: Approved By:
    __________________________ NUP VICTORIA T DE CASTRO
    Records Section Chief ID Section, PRBS
    Processed By: Recommended By:
    ___________________________
    ID Section In-Charge ROSALYN B CABRIGAS
    Police Chief Inspector
    Chief, Pension & Gratuity Div

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