Republic of the Philippines)

City of ________________)

AFFIDAVIT
I ______________________________________, of legal age, single/married,
with postal address at_____________________________________________ after
having duly sworn in accordance with law hereby depose and state:
That I am presently employed with the _________________________________
(Name of School)

as ________________________________;
(Designation.Position)

That I have been employed in _________________________________________

(Name of School)

since____________ or for a period of _______________;

That I was designated as _____________________________ who will participate
(Name of Event)

in the 20___ Regional Meet in __________________ / 20______Palarong Pambansa in

_______________________________;
That I have been coaching since ______________;
That all the athletes records submitted are true and correct to the best of my
personal knowledge;
That all the athletes of _____________________________ who will participate
(Name of Event)

in the 20___ Regional Meet in __________________ / 20______Palarong Pambansa in

_______________________________ are eligible;
That I execute this Affidavit to attest to the authenticity and veracity of all the
documents submitted.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of
______________ 20____ in _______________________, Philippines.
_______________________________
Affiant
(Signature over Printed Name)

SUBSCRIBED AND SWORN TO before me this _______ day of ___________

20___, in ____________________ affiant exhibiting his/her Community Tax Certificate
No. ___________, issued at ____________________ on _______________________.
_______________________
Notary Public
Doc. No. _________
Page No.__________
Book No._________
Series of _________

Note: For Private School Teachers.