Form DCLC-3
AUTHORIZATION TO DEDUCT
(Discounting of Commutation of Leave Credits)
DATE: __________________
TO WHOM IT MAY CONCERN:
In connection with my approved application for the Discounting of Commutation of Leave
Credits with the AFP Retirement and Separation Benefits System (AFP RSBS), I , ________________
___________________________________________________________________________, hereby
authorize the Commanding Officer of AFP Finance Center and Major Finance Service Center/Finance
Service Units to deduct from my approved Commutation of Accumulated Leave/Furlough (CALF) the
amount of ___________________________________________________(PhP_________________)
representing payment to the AFP RSBS for my Discounting of Commutation of Leave Credits.
Conformed by:
BORROWER’S SIGNATURE OVER
PRINTED NAME
SIGNATURE OF AUTHORIZED OFFICER
OF AFP FINANCE CENTER/
MAJOR FINANCE SERVICE UNIT
SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in Quezon City,
this ______ day of ________________ 20____ by ________________________________, who
exhibited to me his/her valid Identification Card ______________________ number _________issued
on _________________ at __________________________________.
Doc No.
_______
Page No. _______
Book No. _______
Series of 201_____.