Republic of the Philippines NATIONAL POLICE COMMISSION PHILIPPINE NATIONAL POLICE POLICE REGIONAL OFFICE 1 OFFICE OF THE CHIEF OF REGIONAL STAFF ‘Camp BGen Oscar M Florendo, Parian, City of San Femando, La Union MEMORANDUM TO 2 See Distribution FROM =: ACRS SUBJECT : Maintenance of Personal Clear Book of all PRO 1 Personnel DATE October 12, 2020 1. References: a. Verbal Instruction of the Regional Director; and b. Requirements needed during Mandatory Schooling, Promotion and Retirement of personnel. 2. This pertains to the guidance our Regional Director that all personnel shall maintain a copy of their personal Clear Book in order for them to have an organized copy of important PNP/personal documents needed during application for Mandatory Schooling, Promotion, Retirement, and other important matters relative to professional development. 3. In this regard, all personnel are encouraged to have a copy of their personal Clear Book for their own convenience. Further attached are the checklists for your ready reference. 4. For guidance and widest dissemination. Distribution: RStait PIS-Staff RHSU RMFB1 All PPOs RSUs Copy Furnished: ‘Command Group [PROT: Home of the Culzon Friendly Policeman and Protector of Human Rights We Support PNP PALI. Plan 2030 (Peace and Onder sends for [ramtormation ad upto he Rak FL)TABLE OF CONTENTS (Requirements) SCHOOLING A PROMOTION RETIREMENT cSCHOOLING MANDATORY FOR PCOS Folder A: Documents (For the Office of the Registrar) ‘Accomplished NPC Enrollment Form; Accomplished Student Information Form; ‘Schooling Order; Bureau Personal Data Sheet (PDS); . Certificate of Mandatory and Specialized Trainings in the last 3 years; DLOD Clearance; and 3 pes of 2x2 I.D. Picture. e-~po0gD Folder B: Medical Requirements (For the NPC Health Service) a. Accomplished Medical Certificate (COVID-Free) from PNP Health Service; b. Electrocardiogram (ECG with readings); c. Drug Test Clearance (From Bureau Accredited Drug Testing Center); and d. Neuro-Psychiatric Examination (From Bureau Accredited NP Testing Center). MANDATORY FOR PNCOS a. Recommendation from Chief, RLDDD; b. Recommendation from Unit Assignment; ¢. Updated Personal Data Sheet (PNP PDS); d. Latest Promotion Order; e. Authenticated Certificate of Diploma/Completion, Final Order of Merit, Declaration of Graduates; f. Eligibility; g. Medical Certificates from Regional Health Service 1 (RHS 1); * ECG * Drug Test Result * Neuro Psychiatric Result * Hepa B h. Pregnancy Test (Female Applicants); i. Certificate of Non-pending Case; © Legal * RIAS * FTOC Certificate/Certification (for PSSLC applicants) - Affidavit of Undertaking relative to the truthfulness of submitted documents; k. Two (2) 2x2 ID picture (colored with headgear in GOA “B" Uniform)ANNEX “1A”. REQUIREMENTS FOR PROMOTION ¢ REQUIREMENTS FOR PROMOTION (2"° LEVEL) FOLDER A (PNP REQUIREMENT) A. Updated and Signed PAIS PDS (Updated and Complete, must be signed by Admin Officer) B. Notarized Affidavit of Undertaking (DPRM FORM RSD-03-A (Revised 2017)) C. Copy of NBI Clearance (Photocopy and Authenticated Photocopy will not be accepted) D. Original Certification from the Court and Quasi-Judi (For those with pending criminal/administrative case/s only) E. Authenticated CSC Attested Appointment on Present Rank (Permanent and Temporary if applicable) FOLDER B (CSC REQUIREMENT for ATTESTATION) Body Checklist of Common Requirements Original Duly Accomplished CSC PDS From 212 (Revised 2017) Authenticated Proof of Mandatory Training ¢.1) Certificate of Mandatory Training Finished; ¢.2) Final Order of Merit; and ¢.3) Declaration of Graduates. Authenticated Proof of Eligibility . Authenticated CSC Attestation on Present Rank (Permanent and Temporary if applicable E. DBM-CSC Form No. 1 CS Form No. 4 (Certificate of Assumption to Duty) G. CS Form No. 32 (Oath of Office) — to be submitted and signed by the Appointing Officer/Authority/Head of Office QP mo Aus Note: FOLDERS submitted with incomplete data and no signature on the documents (for PNP Generated PAIS PDS and CSC PDS) will not be accepted. Please check properly your folders before submitting to the respective Promotion Secretariat of your Unit/Office.DOCUMENTARY REQUIREMENTS FOR REQUISITION OF CLEARANCES FROM HIGHER HEADQUARTERS A. FOR DC CLEARANCE (2 COPIES EACH) - Retirement Order - Certificate of Last Payment B. FOR DL CLEARANCE (6 COPIES EACH) - Retirement Order RSAO (Non Property Accountability) Commel Clearance RHSU Clearance Property Turn — in Slip Updated Service Record C. FOR DLOD Clearance (1 COPY EACH) - Retirement Order - Non pending Case - Duty Status (records) - Xerox Copy of PNP ID D. FOR OMBUDSMAN Clearance (2 COPIES EACH) - Retirement Order - Updated Service Record - Xerox Copy of PNP IDREQUIREMENTS FOR 36 MONTH LUMP SUM/ OUTRIGHT PENSION/GRATUITY (2 copies each) A, RETIREMENT ORDER B. SERVICE RECORDS RMD C, LATEST PROMOTION ORDER D, DIRECTORATE FOR COMPTROLLERSHIP (DC) CLEARANCE E, DIRECTORATE FOR LOGISTICS (DL) CLEARANCE F. DLOD CLEARANCE (ORIGINAL) . NAPOLCOM CLEARANCE(ORIGINAL) . OMBUDSMAN CLEARANCE (ORIGINAL) CERTIFICATE OF LAST PAYMENT (CLP) STATEMENT OF ASSETS, LIABILITIES & NET WORTH (SALN) ORIGINAL K. 2X 2 PICTURE W/ NAMETAG . STH (Land Bank Account Number) M. ADDITIONAL REQUIREMENT ae ea = *ADDITIONAL REQUIREMENT FOR OUTRIGHT PENSION N. AFFIDAVIT STATING THAT HE/SHE IS WAIVING HIS/HER RIGHT FOR PAYMENT OF THE THREE (3) YEARS LUMP SUM AND OPTING TO BE PAID THROUGH OUTRIGHT PENSION. Note: After completion of requirements above, retiree shall report to PRBS. or nearest PRBU for updating and subsequently opening of ATM pension account (STI). All Xerox copies must be duly authenticated by issuing unit.REQUIREMENTS FOR COMMUTATION OF ACCRUED LEAVE (2 copies each) Rank/Name of Retiree: Unit: Date of Ret/Sep: Mode of Ret/Sep: Requirements: Retirement Order Updated Service Record RMD Commutation Order Breakdown of Leave Credits RMD Latest Promotion Order Certificate of Non-Money/Property Clearance (RFSO1, RHSU & COMMEL) DC Clearance DL Clearance (RSAO, PTIS) Certificate of Last Payment SALN 2x 2 Picture w/ nametag Affidavit of Authorization to Deduct All Financial Obligations (original copy) STI 1/ATM Pension Account Contact Number Additional Requirement ¢ Additional Requirements for Deceased PNP Personnel Decree of Entitlement Certificate of Declared Legal Beneficiaries Death Certificate Marriage Contract (if Single - MC of Parents) Advisory of Marriages (Both) Birth Certificate of All Children Birth Certificate (Husband/Wife) Certificate of No-Marriage (if single) 1x1 picture of PNP Personnel Approved Line of Duty (LOD) Status * Two (2) copies each * AllXerox copies must be duly authenticated * All family documents are NSO copy with receipts -1 original and two (2) photocopyREPUBLIC OF THE PHILIPPINES... CITY OF SAN FERNANDO, LA UNION... so) )S.s. AFFIDAVIT OF AUTHORIZATION TO DEDUCT 1 (Ret), of legal age, ino, Married/Single, formerly assigned at and with postal Address at After having duly sworn to in Accordance with law do hereby depose and state: That, 1 retired Compulsory/Optionally/TPPD effective Pursuant to S.0./G.0. Number dated That, prior to my retirement, | have an/no outstanding Loan Balance from the PNP Provident Fund / Firearms Accountability Overpayment amounting to P : That, in view with above | am authorizing the Retirement Claims and Funds Management Division (RCFMD) and/or Pension and Gratuity Division (PGD) of PNP Retirement and Benefits Administration Service (PRBS) to deduct said amount from my Commutation of Accumulated Leave (CAL) claims and/or Lump Sum/Retirement Gratuity Claims; That, | am executing this Affidavit to the truthfulness of the foregoing facts and for whatever legal purpose this may serve. In witness whereof, | have hereunto affixed my signature this day of 20__ at Philippines. Signature over Printed Name (Affiant) SUBSCRIBE AND SWORN to before me this day of. eee at ilippines.REQUEST FOR OPTIONAL RETIREMENT 1 FOLDER (1 ORIGINAL AND 2 COPIES XEROX DULY AUTHENTICATED) ENDORSEMENT FROM UNIT/PPO/REGION - - - -- -- A BASIC LETTER REQUEST ------------------- B AFFIDAVIT OF NON IRREVOCABLE - ------------ ic UPDATED SERVICE RECORD FROM RMD DPRM - --D AUTHORIZATION TO DEDUCT - - ee _--_E—E F NOTE: For OPTIONAL RETIREMENT — MUST REACH PRBS ONE (1) YEAR PRIOR EFFECTIVE DATEREPUBLIC OF T’HE PHILIPPINES.. ) ) SS. CITY OF SAN FERNANDO, LA UNION.... AFFIDAVIT OF AUTHORIZATION TO DEDUCT 1, ( Ret), of legal age, Filipino Married/Single, formerly assigned at and with postal Address at After having duly sworn to in Accordance with law do hereby depose and state: That, | retired Compulsory/Optionally/TPPD effective Pursuant to 8.0. /G.O. Number dated That, prior to my retirement, | have an outstanding Loan Balance from the PNP Provident Fund / Firearms Accountability Overpayment amounting to Pp. ee That, in view with above | am authorizing the Retirement Claims and Funds Management Division (RCFMD)andior Pension and Gratuity Division (PGD) of PNP Retirement and Benefits Administration Service (PRBS) to deduct said amount from my Commutation of Accumulated Leave (CAL) claims and/or Lump Sum/Retirement Gratuity Claims: ‘That, | am executing this Affidavit to the truthfulness of the foregoing facts and for whatever legal purpose this may serve. In witness whereof, | have hereunto affixed my signature this day of 20___ at Philippines. Signature over Printed Name (Affiant) SUBSCRIBE AND SWORN to before me this. day of 20__at Philippines. Series No.REPUBLIC OF THE PHILIPPINES) San Fernando City, La Union...) 8.8 AFFIDAVIT OF IRREVOCABLE UNDERTAKING TO AVAIL OF OPTIONAL RETIREMENT 1 » Badge Number Unit Assignment of legal age, married, a bonafide member of the Philippine National Police a resident of . after having been duly sworn to accordance with law, do hereby depose and say: 1. That I have filed my application for optional Retirement from the PNP service pursuant to Section 40 of RA 6975, 2. That the effective date ofmy Optional Retirement effective is on 3. That once order is issued in connection with my Optional Retirement, | will Rot request nor ask for the revocation of same; and 4. That, | am executing this affidavit voluntarily and to support the issuance of Retirement Order, FURTHER, AFFIANT SAYETH NONE: IN WITNESS WHEREOF, | hereunto set my hand this day of at 5 Affiant SUBSCRIBED AND SWORN to before me this day of at » Philippines. Notary Public Doc No. Page No. Book No. Series No.