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AUTHORIZATION FOR DEDUCTION AND REMITTANCE
(DEED OF UNDERTAKING)
To whom it may concern:
I, __________________________________________________________________ a member of PNP/__________ (Branch of Service) and a loan applicant of Public Safety Savings and Loan
Association, Inc. (PSSLAI), do hereby authorize the ________________________________ to deduct from my monthly payroll / monthly pension / retirement benefits / commutation of
leaves and pay the amount of (Php_________________________________) ___________________________________________________________________________ until my loan obligation is fully paid.
This authorization shall not be rescinded or revoked without the written approval of PSSLAI. If this authorization is not timely effected on my behalf, I shall pay the unpaid amount
and/or penalties thereof.
This will likewise serve as an authorization for the ____________________ to release in favour of PSSLAI whatever amount due to them in case of separation, dismissal, resignation,
termination and other causes not herein mentioned whatsoever. I am allowing the PNP/__________ (Branch of Service) to deduct more than the allowed percentage of benefits that
can be remitted as payment for any liabilities incurred by me. We concur that PSSLAI shall be given first priority in any benefit we will receive against any loan obligation from
other institution. This authority shall be in full force until my loan is fully paid. It does not relieve me of my obligation to ensure that the deductions are made from my salary/
pension/other benefits and remitted to PSSLAI.
Pursuant to Republic Act 8792 otherwise known as the E-Commerce Act of 2000 in relation to Republic Act 8367 otherwise known as the Revised Non-Stock Savings and Loan
Association Act of 1007, by availing of loan from PSSLAI through its electronic data facilities, that by virtue of the nature of this transaction, one being constituted upon electronic
means and/or computer generated, I fully understand that NO PHYSICAL SIGNATURE may be required of me but my agreement of the terms and conditions governing the loan is
sufficiently manifested by the fact of my use of the electronic/computerized loan facility provided by PSSLAI. A digital/ electronic signature may be provided evidencing my full
agreement and consent to this transaction.
BORROWER’S SIGNATURE OVER PRINTED NAME
ACKNOWLEDGEMENT
BEFORE ME, a Notary Public for _________________, this ______day of __________, 20_______, personally appeared who exhibited to me his/her competent evidence of identification
(CEI) the details of which are provided next to their names as follows:
NAME ___________________________________________________ CEI PRESENTED ______________________________________
ISSUED AT __________________________________ ON ______________________________________ VALID UNTIL ____________________________________
Known to me to be the same persons who executed the foregoing instrument and acknowledged to me that the same is his free and voluntary act and deed.
WITNESS MY HAND AND SEAL at the place and on the date first mentioned.
Doc. No. ___________
Page No. ___________
Book No. ___________
Series of 2014.