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    Pensioner's Update Form PDF

    Uploaded by

    Karen Virrey
    This document is a pensioner's update form from the Bureau of Jail Management and Penology of the Philippines. It collects personal information such as name, address, date of birth, civil status, and dependent children from retired jail personnel or their survivors to update pension records. The form requests an ID photo, personnel service details, and requires verification and signature to certify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Pensioner's Update Form PDF

    Uploaded by

    Karen Virrey
    133 views1 page
    This document is a pensioner's update form from the Bureau of Jail Management and Penology of the Philippines. It collects personal information such as name, address, date of birth, civil status, and dependent children from retired jail personnel or their survivors to update pension records. The form requests an ID photo, personnel service details, and requires verification and signature to certify the accuracy of the information provided.

    Original Title

    PENSIONER'S UPDATE FORM.pdf

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    This document is a pensioner's update form from the Bureau of Jail Management and Penology of the Philippines. It collects personal information such as name, address, date of birth, civil status, and dependent children from retired jail personnel or their survivors to update pension records. The form requests an ID photo, personnel service details, and requires verification and signature to certify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    133 views1 page

    Pensioner's Update Form PDF

    Uploaded by

    Karen Virrey
    This document is a pensioner's update form from the Bureau of Jail Management and Penology of the Philippines. It collects personal information such as name, address, date of birth, civil status, and dependent children from retired jail personnel or their survivors to update pension records. The form requests an ID photo, personnel service details, and requires verification and signature to certify the accuracy of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Republic of the Philippines

    DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT


    BUREAU OF JAIL MANAGEMENT AND PENOLOGY
    National Headquarters
    144 Mindanao Avenue, Project 8, Quezon City
    ————————————————————————————————————-

    ID picture taken within


    the last 6 months
    3.4 cm x 4.5 cm
    PENSIONER’S UPDATE FORM (passport size)
    Computer generated
    or Xerox copy of
    picture is not
    acceptable

    PERSONNEL DATA
    NAME (RANK) SURNAME (GIVEN NAME) (MIDDLE NAME) RETIREMENT RANK
    I I I

    ADDRESS (NUMBER & STREET) (BARANGAY) (TOWN/DISTRICT) (CITY/PROVINCE) POSTAL CODE


    I I I I

    PLACE OF BIRTH (NUMBER & STREET) (BARANGAY) ( TOWN/DISTRICT) (CITY/PROVINCE)


    I I I

    DATE OF BIRTH (MM/DD/YYYY) DATE ENTERED GOV’T SVC (MM/DD/YYYY) DATE OF RET/SEPARATION (MM/DD/YYYY) CIVIL STATUS
    I I I

    SPOUSE (SURNAME) (GIVEN NAME) (MIDDLE NAME)


    I I

    DEPENDENT CHILDREN DATE OF BIRTH CHECK APPLICABLE COLUMN CIVIL STATUS ADDRESS
    (unmarried, below 18 yrs old) LEGITIMATE ILLEGITIMATE

    1. ________________________ ______________ ___________ ______________________


    2. ________________________ ______________ ___________ ______________________
    3. ________________________ ______________ ___________ ______________________
    4. ________________________ ______________ ___________ ______________________
    (use separate sheet if necessary)

    (IN CASE PRINCIPAL PENSIONER IS ALREADY DECEASED) ID picture taken within


    NAME OF SURVIVOR the last 6 months
    (SURNAME) (GIVEN NAME) (MIDDLE NAME) 3.4 cm x 4.5 cm
    I I (passport size)
    Computer generated
    ADDRESS (NUMBER & STREET) (BARANGAY) (TOWN/DISTRICT) (CITY/PROVINCE) POSTAL CODE
    or Xerox copy of
    I I I I
    picture is not
    DATE OF BIRTH (MM/DD/YYYY) RELATIONSHIP TO JAIL PERSONNEL DATE OF DEATH OF JAIL PERSONNEL acceptable
    I I

    Pls. Check appropriate box REMAIN SINGLE REMARRIED

    I CERTIFY under pain of perjury or falsification that all the above information are true and correct:

    ____________________________________________ _________________
    (PENSIONER’S SIGNATURE OVER PRINTED NAME) DATE

    Verified by: Remarks:

    ___________________
    _____________________________________________
    Date

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