_____________________

Date

CIVIL SERVICE COMMISSION

Subject: Request for Certificate of No Pending Administrative Case

Sir/Madam:

May I respectfully request your good office to issue Certificate of No Pending Administrative Case in my favor which shall be used for the
purpose/s indicated below:
a. ________ promotion
b. ________ retirement
c. ________ others (pls. specify) _____________________________.

Your immediate attention on this matter will be greatly appreciated.

To be filled up by CSC Personnel Very truly yours,

____________________________________
OLA/LSD Signature
Verified by: _____________________________
____________________________________
Last Name First Name M.I.
Payment for Certificate of No Pending Administrative Case= P100.00
Cashier ____________________________________
O.R. No. ________________________________ Home Address

____________________________________
Date: __________________________________ Present Position

Issued by: _______________________________ ____________________________________

____________________________________
Name of Agency/Address
Certificate No. : _________________________________ Received by:
________________________

_____________________
Date

CIVIL SERVICE COMMISSION

Subject: Request for Certificate of No Pending Administrative Case

Sir/Madam:

May I respectfully request your good office to issue Certificate of No Pending Administrative Case in my favor which shall be used for the
purpose/s indicated below:
a. ________ promotion
b. ________ retirement
c. ________ others (pls. specify) _____________________________.

Your immediate attention on this matter will be greatly appreciated.

To be filled up by CSC Personnel Very truly yours,

____________________________________
OLA/LSD Signature
Verified by: _____________________________
____________________________________
Last Name First Name M.I.
Payment for Certificate of No Pending Administrative Case= P100.00
Cashier ____________________________________
O.R. No. ________________________________ Home Address

____________________________________
Date: __________________________________ Present Position

Issued by: _______________________________ ____________________________________

____________________________________
Name of Agency/Address
Certificate No. : _________________________________ Received by:
________________________