Republic of the Philippines )
_____________________ ) SS.
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AFFIDAVIT OF UNDERTAKING FOR TERMINAL LEAVE
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 presently employed in the Commission on Audit and due for compulsory/optional retirement on ______________________________.
2. That I have applied for Terminal Leave effective _______________________.
3. That pre-audit of financial transactions of national government agencies, among others, has been lifted per COA Circular 2011-002 dated July 22, 2011.
4. That should it appear in post-audit there was overpayment in the money value of my terminal leave, I am willing to refund of any excess amount thereon;
5. That on the other hand, if it will appear in post-audit that I was underpaid in my terminal leave benefits, it is understood that the Commission on Audit shall pay me the difference of the amount corresponding to the underpayment; and,
6. That I am executing this affidavit to attest to the truth to all the above facts.
IN WITNESS WHEREOF, I have set my hand and affixed my signature this _________ day of ______________, 20 ______ at _______________________.
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 _____