OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES

CITY OF SAN JUAN
AFFIDAVIT
I, ___________________________________________________ of legal age,
(married/single), Filipino, and residing at
___________________________________________. After having been duly sworn
in accordance with law, do hereby depose and state that:
1. I am a qualified teacher applicant at
______________________________________;
2. I am executing this omnibus sworn certification to assure
authenticity and vericty of all documents submitted;
3. I assume full responsibility and accountability on the validity
of documents submitted and I understand that any violation will
automatically disqualify me from the selection process.
IN WITNESS WHEREOF , I have hereunto set my hands this
___________ day of January, 2015 at San Juan City, Metro manila
Philippines

________________________________
Printed Name and Signature of
Applicant

SUBCRIBED AND SWORN TO before me this _________________ day of

January, 2015, affiant exhibiting to me his/her Community Tax No.
_________________________________ issued on
___________________________________ at ______________________________ ,
Philippines.

____________________________
Notary Public