Share

Affidavit for Anti-Graft and Corrupt Practices

COA affidavit for anti-graft and corrupt practices under R.A 3019

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
______________
) S.S.

AFFIDAVIT FOR ANTI-GRAFT AND CORRUPT PRACTICES (RA 3019)

I, __________________________________, of legal age, Filipino, single/married/
widow/widower and a resident of _________________________________________________,
after having been duly sworn to in accordance with law, hereby voluntarily depose and say:
1. That I am currently/formerly employed as
in the Commission on Audit.

________________________________

2. That I am retiring/ under RA 1616/PD 1146/RA 8291 to take effect/effective on
_______________________.
3. That there is no administrative or criminal investigation against me for any offense,
defined or penalized under RA 3019, otherwise known as the Anti-Graft and Corrupt
Practices Act, as amended, and under the provisions of the Revised Penal Code on
Bribery; and
4. That I am executing this affidavit to attest to the truth of the foregoing facts or
assertation in compliance with COA Memorandum No. 451 dated March 6, 1973.
IN WITNESS HEREOF, I have set my hand and affixed my signature this _____day of
_____________, 20______ at ___________.

(Affiant)

SUBSCRIBED AND SWORN TO BEFORE ME this _______ day of _________
___________, 20 ______, affiant exhibited to me his Government Issued ID
__________No.______________ issued at __________________ on ____________________.

Doc. No. ________
Page No. ________
Book No. ________
Series of ________

NOTARY PUBLIC
 
Page of
Share