Undertaking of Requesting Party Form

CSC SALN request form for undertaking party

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Summary List of Filers
Statement of Assets, Liabilities and Networth
Calendar Year ________________

This is to certify that the SALNs submitted/ included in the Summary List of Filers were reviewed and found compliant by the Review and
Compliance Committee of this Office.
Further, the review were made in accordance with the review and compliance procedure in filing and submission of SALNs pursuant to
CSC Memorandum Circular No. 10, s. 2006 (as amended by CSC Resolution No. 1300455 promulgated on March 04, 2013).
Issued on _____________, ________.

Name and Signature

Name and Signature

Name and Signature

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