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Affidavit of Undertaking for PFMS

COA affidavit of undertaking for planing, finance and management sector if terminal leave is not sufficient to cover loans

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______________
) S.S.

AFFIDAVIT OF UNDERTAKING FOR PLANNING, FINANCE AND MANAGEMENT
SECTOR (PFMS)

I, ________________________, of legal age, Filipino, and a resident of
_____________________, after having been duly sworn to in accordance with law, hereby voluntarily
depose and say:
1. That I was an employee of the Commission on Audit (COA) effective __________;
2. That I have applied for GSIS retirement benefits effective _______________;
3. That I have an outstanding bill in the Accounting Office, Planning, Finance and
Management Sector (PFMS), Commission on Audit (COA);
4. That I hereby commit to pay my outstanding bill in the Accounting Office, Planning,
Finance and Management Sector (PFMS), Commission On Audit, from the proceeds of
my GSIS Retirement benefits;
5. That I am authorizing Government Service Insurance Corporation (GSIS) to remit to
Accounting Office, Planning, Finance and Management Sector (PFMS), Commission on
Audit, the amount of ______________ which represents my COA Bill, out of the
proceeds of my retirement benefits;
6. That I am executing this affidavit to attest to all the above facts.
IN WITNESS HEREOF, I have hereunto signed my name below this _________day of
_____________,20______ at ___________.

(Affiant)

SUBSCRIBED AND SWORN TO BEFORE ME this _______ day of _________,20______,
affiant exhibited to me his/her Government issued ID __________ No._________________ issued at
__________ on ____________,20 __________.

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

NOTARY PUBLIC
 
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