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  • Affidavit of Accident

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    Greg Trinidad
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    This document is an undertaking signed by a public official applying for a Certificate of Authority-Law Enforcement Agency from the Commission on Elections. The official certifies that they are currently employed in a law enforcement role, are authorized to apply for the certificate, and that the firearms they will carry are properly licensed and registered. The official understands any misrepresentation could result in denial or revocation of the certificate application and potential legal charges.

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    affidavit of undertaking accident report

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    This document is an undertaking signed by a public official applying for a Certificate of Authority-Law Enforcement Agency from the Commission on Elections. The official certifies that they are currently employed in a law enforcement role, are authorized to apply for the certificate, and that the firearms they will carry are properly licensed and registered. The official understands any misrepresentation could result in denial or revocation of the certificate application and potential legal charges.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    32 views2 pages

    Affidavit of Accident

    Uploaded by

    Greg Trinidad
    This document is an undertaking signed by a public official applying for a Certificate of Authority-Law Enforcement Agency from the Commission on Elections. The official certifies that they are currently employed in a law enforcement role, are authorized to apply for the certificate, and that the firearms they will carry are properly licensed and registered. The official understands any misrepresentation could result in denial or revocation of the certificate application and potential legal charges.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    I, ____________________________________________ of legal age, Filipino, and with office address located at

    ________________________________________________________________________________, after having been


    duly sworn to in accordance with law, do hereby undertake that:

    1. I am presently an Official of _______________________________________________________


    (Department/Agency), as _____________________________________________________________
    (position/rank and employment status), performing actual law enforcement functions and receiving
    regular compensation for the services rendered in the said agency. Attached hereto as Annex “A” is
    a certified true copy of my Certificate of Appointment (for appointed officials);

    2. I am authorized to apply for a Certificate of Authority-Law Enforcement Agency (CA-LEA) under


    COMELEC Resolution No. 10015.

    3. The firearms I will bear and carry are described in Form 16A-01A attached hereto and contained in
    the compact disc (CD). The data therein are real, true and correct, particularly the following:

    a. Kind;
    b. Make/Model;
    c. Caliber;
    d. Serial number;
    e. CFR No./LCR No./MR No./ARE No.;
    f. PTCFOR No. /Mission Order No. /Letter Order No.

    4. All the applicable and required permits and license are still valid, updated and will not expire
    during the election period from January 10, 2016 (SUN) to June 08, 2016 (WED). Attached hereto
    as Annex “B” are photocopies of the said licenses and permits.

    5. I understand that any misrepresentation or false statement in this Undertaking or its attachments
    shall be a ground for the denial of the application or the revocation of an approved Certificate of
    Authority. This is without prejudice to the filing of the appropriate criminal, civil, administrative,
    and/or election offense charge/s.

    6. The statements stated herein are all willingly, freely and voluntarily executed to attest to the truth
    of the foregoing facts in connection with this application above-mentioned.

    IN WITNESS WHEREOF, I have hereunto affixed my signature and seal of my office on this ____day
    of __________, 201____, in the City/Municipality of _____________________________, Philippines.

    _________________________________
    Public Official
    (Name and Signature)

    Republic of the Philippines)


    City/Municipality of _____________________________ )S.S.

    SUBCRIBED AND SWORN TO BEFORE me this ____ day of ________________ 201___, in the
    City/Municipality of _____________________________, Republic of the Philippines personally appeared to me
    ___________________________ with Identification No. _____________ issued by _____________ on
    _______________________ in _________________.

    Page 1_of 1_
    PNP/AFP/LEA - Individual
    Notary Public/Administering Officer

    Document No.: ___________


    Page No. : ___________
    Book No. : ___________
    Series of 201 ____

    Page 1_of 1_
    PNP/AFP/LEA - Individual

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