CS Form No.

4
Series of 2017

Republic of the Philippines

NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
POLICE REGIONAL OFFICE 13 (CARAGA)
Camp Col Rafael C Rodriguez, Butuan City

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms/Mr. Marle M Dominguez has assumed the duties
and responsibilities as Police Officer 1 of Police Regional Office 13 effective
__________________.

This certification is issued in connection with the issuance of the

appointment of Ms/Mr Marle M Dominguez as Police Officer 1.

Done this _____ day of July 2018 in Camp Col Rafael C Rodriguez,
Butuan City.

NOLI A ROMANA
Police Chief Superintendent
Regional Director, PRO13

Date:

Attested by

RINGO C ZARZOSO
Police Superintendent
OIC, Regional Personnel and
Human Resource Development Division