Republic of the Philippines
City of Caloocan
)
) S.S.
AFFIDAVIT OF NON-REVOCABLE FOR RETIREMENT
I, SPO4 GUILLERMO VERGARA AZAÑES, JR., a member of the Philippine
National Police as Non-Commissioned Officer, 56 years of age, married, presently
residing at No. 9 Gen. Isagani Campo St., Bankers Village II, Tala, Caloocan City, after
having been sworn to in accordance to Law do hereby depose and states.
That I am a bonafide member of the Philippine National Police, presently
assigned at DSHG/NPDO, Caloocan City.
That the undersigned issue this affidavit of non-revocable for compulsory
retirement from the PNP service with 5th L/P pursuant to section 39 and 74 of RA 6975 in
relation to Section 34 of RA 8551 with one rank higher for purposes of retirement pay.
Effective September 19, 2005 by virtue and command of NATIONAL
HEADQUARTERS, PHILIPPINE NATIONAL POLICE, P/DGen EDGARDO B
AGLIPAY, signed by Director for Personnel and Record Management, P/CSupt
NICOLAS PASINOS, pursuant to paragraph 1 of Special Order No. 559 dated March 7,
2005.
That I executed this affidavit to attest to the truth of the above and the foregoing
facts and for whatever purpose or purposes this might be of legal worth.
IN WITNESS HEREOF, I affixed my signature below, this 5th day of September
2005 here at Caloocan City.
SPO4 GUILLERMO V AZAÑES, JR.
Affiant
SUBSCRIBE AND SWORN to before me this ___________ day of September,
2005 in the City of Caloocan Metro Manila.
Doc. No. _______________
Page No. _______________
Book No. ______________
Series of _______________
CALOOCAN CITY POLICE MULTI-PURPOSE COOPERATIVE
Pay period 01-15 September
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
SPO2 JOEL L. LOPEZ
PO2 MARTIN W. SOLA
PO2 MA. CECILIA Q. MENDOZA
PO3 RENATO B. ABLAZA JR.
SPO2 FELIMON L. ARENAS
PO3 ERNESTO F. DARIA JR
PO2 ALBERTO B. DIMAZANA
SPO2 BAYANI U. GOTERA
SPO4 FLORENCIO D. RAMIREZ JR.
SPO2 JONATHAN L. REGALA
PO2 TIRSO D. RONCALES JR.
POI JOSELITO R. VIACRUSIS
SPO2 ANTONIO S. PEÑARANDA
PO3 GERALDINE Q. HALNIN
P
19.00
20.00
20.00
19.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
---------------------P
278.00
Financial Assistance
(PO3 JESUS GARCIA)
Received by:
_____________________
Printed name & Signature
CALOOCAN CITY POLICE MULTI-PURPOSE COOPERATIVE
Pay period 01-15 September
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
SPO2 JOEL L. LOPEZ
PO2 MARTIN W. SOLA
PO2 MA. CECILIA Q. MENDOZA
PO3 RENATO B. ABLAZA JR.
SPO2 FELIMON L. ARENAS
PO3 ERNESTO F. DARIA JR
PO2 ALBERTO B. DIMAZANA
SPO2 BAYANI U. GOTERA
SPO4 FLORENCIO D. RAMIREZ JR.
SPO2 JONATHAN L. REGALA
PO2 TIRSO D. RONCALES JR.
POI JOSELITO R. VIACRUSIS
SPO2 ANTONIO S. PEÑARANDA
PO3 GERALDINE Q. HALNIN
Financial Assistance
(PO3 JESUS GARCIA)
Received by:
_____________________
Printed name & Signature
P
19.00
20.00
20.00
19.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
20.00
---------------------P
278.00
CALOOCAN CITY POLICE MULTI-PURPOSE COOPERATIVE
Pay period 15-30 September
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
SPO2 JOEL L. LOPEZ
PO3 NICAH C. BELO
PO2 MA. CECILIA Q. MENDOZA
PO3 RENATO B. ABLAZA JR.
SPO2 FELIMON L. ARENAS
PO3 ERNESTO F. DARIA JR
PO2 ALBERTO B. DIMAZANA
SPO2 BAYANI U. GOTERA
SPO4 FLORENCIO D. RAMIREZ JR.
SPO2 JONATHAN L. REGALA
PO2 TIRSO D. RONCALES JR.
P/INSP JOVEN DELA PIEDRA
SPO2 ANTONIO S. PEÑARANDA
PO3 GERALDINE Q. HALNIN
PO3 ENRIQUE A. TORRES
P
40.00
20.00
20.00
20.00
40.00
20.00
20.00
40.00
40.00
40.00
20.00
100.00
40.00
20.00
20.00
---------------------P
500.00
DECEASED
(PO1 JOEL CATAMA)
Received by:
_____________________
Printed name & Signature
CALOOCAN CITY POLICE MULTI-PURPOSE COOPERATIVE
Pay period 15-30 September
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
SPO2 JOEL L. LOPEZ
PO3 NICAH C. BELO
PO2 MA. CECILIA Q. MENDOZA
PO3 RENATO B. ABLAZA JR.
SPO2 FELIMON L. ARENAS
PO3 ERNESTO F. DARIA JR
PO2 ALBERTO B. DIMAZANA
SPO2 BAYANI U. GOTERA
SPO4 FLORENCIO D. RAMIREZ JR.
SPO2 JONATHAN L. REGALA
PO2 TIRSO D. RONCALES JR.
P/INSP JOVEN DELA PIEDRA
SPO2 ANTONIO S. PEÑARANDA
PO3 GERALDINE Q. HALNIN
PO3 ENRIQUE A. TORRES
DECEASED
(PO1 JOEL CATAMA)
Received by:
_____________________
Printed name & Signature
P
40.00
20.00
20.00
20.00
40.00
20.00
20.00
40.00
40.00
40.00
20.00
100.00
40.00
20.00
20.00
---------------------P
500.00
TABLE OF CONTENTS
UPDATED PERSONAL DATA SHEET(PDS)
-------------------------------------------------(A)
ABSORPTION ORDER
-------------------------------------------------(B)
APPOINTMENTS
Original
Promotion
Reappointment
-------------------------------------------------(C)
OATH(S)
-------------------------------------------------(D)
DESIGNATION ORDER (Head of Offices/Units)
-------------------------------------------------(E)
SPECIAL ORDER OF ASSIGNMENTS
(Place/Nature)
Within the PS, PPO, RO
DS with other PNP Offices/Units
DS with VIPs
-------------------------------------------------(F)
UPDATED SERVICE RECORD
------------------------------------------------(G)
ATTESTED APPOINTMENT (Patrolman, POI to Present Rank)
LEAVE RECORD
------------------------------------------------(H)
RECORD OF EDUCATIONAL ATTAINMENT
Diploma
Transcript of Record/Cert. of Units earned
-------------------------------------------------(I)
REPORT OF RATING (Eligibility)
-------------------------------------------------(J)
CERTIFICATE OF TRAINING/
Final Order of Merit/Career Course
------------------------------------------------(K)
AWARDS AND COMMENDATIONS
-------------------------------------------------(L)
LATEST Individual Performance
Evaluation Rating
------------------------------------------------(M)
CERTIFICATE OF DUTY STATUS
From Unit
------------------------------------------------(N)
SWORN STATEMENT OF ASSETS
AND LIABILITIES
------------------------------------------------(O)
INCOME TAX RETURN
------------------------------------------------(P)
MEMORANDUM RECEIPT OF
ISSUED SERVICE FIREARMS
------------------------------------------------(Q)
MEDICAL RECORDS
(Neuro Psyhiatric test/Drug test)
------------------------------------------------(R)
DENTAL RECORDS
------------------------------------------------(S)
HANDWRITING SPECIMEN
------------------------------------------------(T)
FAMILY DOCUMENTS
(Marriage Certificate/Birth Certificate)
------------------------------------------------(U)
OTHER ORDERS
(Replacement Clothing Allowance/Longevity Pay)
------------------------------------------------(V)
SPECIAL ORDER
re: Disciplinary Penalties Imposed
------------------------------------------------(W)
RECORD/CERTIFICATION
re: Pending Case
------------------------------------------------(X)