Republic of the Philippines)

Province of APAYAO)

AFFIDAVIT

I CATHERYN U. LAGRAN, of legal age, with postal address at SAN FRANCISCO,

LUNA, APAYAO after having duly sworn in accordance with law hereby depose and state:

That I am presently employed in FLORA NATIONAL HIGH SCHOOL as

TEACHER II;

That I am presently employed in FLORA NATIONAL HIGH SCHOOL since

JUNE 18, 2018 or for a period of SEVEN MONTHS;

That I was designated as coach of the TAEKWONDO who will participate in the
2019 CARAA meet.

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 TAEKWONDO, who will participate in the 2018 Provincial
Meet, are eligible to play;

That I execute this Affidavit to attest to the authenticity and veracity of all the
documents submitted.

______________________, __________________

CATHERYN U. LAGRAN
Affiant

SUBSCRIBED and sworn to before me in ______________, this 11 th day of October

2018, affiant executing his/her Community Tax Certificate No.______________, issued at
_______________________ on ________________, 2019.

_______________________
Notary Public

Doc. No. _________

Page No.__________
Book No._________
Series of _________

FOR PALARONG PAMBANSA ONLY