Republic of the Philippines)

City of ________________)

AFFIDAVIT
I _______________________, of legal age, __________________, with postal
address at__________________________________________ after having duly sworn in
accordance with law hereby depose and state:
That I am presently employed in _______________________as ________________ ;
That I am presently employed in ______________________ since _______________
or for a period of _______________;
That I was designated as coach of the _____________________________;
____________________ who will participate in the 20___ Division, Region and Palarong
Pambansa.
That all the athletes records submitted are true and correct to the best of my personal
knowledge;
That all the athletes are not members of the National Team, National Training Pool
and Development Pool receiving monthly stipend/allowance from the Philippine Sports
Commission (PSC);
That all the athletes of _____________________________________, ____________
______________, who will participate in the 20___ Division, Region and Palarong
Pambansa are eligible to play;
That I execute this Affidavit to attest to the authenticity and veracity of all the
documents submitted.
______________________, __________________
__________________
Affiant

SUBSCRIBED and sworn to before me in ______________, this day

____________of month 20___, affiant executing his/her Community Tax Certificate No.
___________, issued at _________ on _____________.
_______________________
Notary Public
Doc. No. _________
Page No.__________
Book No._________
Series of _________