Declaration of Recipient PDF

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DECLARATI

ONOFRECI
PIENT

I
,Dast inB.Demaf el
i
z,Fi l
ipi
nociti
zen,oflegalage,andar esidentofB122L8P3AMabuhay
Homes,Dar angan,Binangonan,Ri zal
,dulyst at
esthatIam af i
rstti
mer eci
pientofcash
assistancefrom theNat ionalGovernmentt hr
oughtheAssi stanceProgram oft
heNCCAand
hasnotbeenabenef i
ciaryofanyoft hef oll
owi
nggov ernmentagenciesandanyassi st
ance
program undertheJointMemor andum Ci
rcularNo.1,s.2020:

1.TUPADoft
heDepar
tmentofLabor(
DOLE)
;

2.SAPoft
heDepar
tmentofSoci
alWel
far
eandDev
elopment(
DSWD)
;

3.Fi
rstBat
choft
heNCCAAssi
stancePr
ogr
am;

4.Assi
stancePr
ogr
am oft
heAr
ti
sts’
Wel
far
eoft
hePhi
l
ippi
nes,
Inc.suppor
tedbyNCCA;

5.DEARoft
heFi
l
m Dev
elopmentCounci
loft
hePhi
l
ippi
nes;

6.Assi
stancePr
ogr
am oft
heFi
l
m Academyoft
hePhi
l
ippi
nessuppor
tedbyt
heNCCA;

7.Ot
herpr
ogr
amsandassi
stancespear
headedbyt
heNat
ional
Gov
ernment
.

Iherebyauthor i
zet heNCCAort heirdulyauthori
zer epr
esentati
ve/stoobtainandsecur ef r
om
allappropri
ategov ernmentagencies,includi
ngbutnotl imitedto:Depart
mentofI nteri
orand
LocalGov ernment ,Depart
mentofSoci alWel f
areandDev elopment,andt heDepar tmentof
LaborandEmpl oy mentsuchdocument st hatmayshowr eceiptoravai
lmentofot herformsof
assist
ancepr ovidedduri
ngt hi
stimeofPubl i
cHealthEmer gencyduet oCov i
d-19.Otherwise,i
f
foundandpr ovent obear eci
pientofot herassist
ancepr ogram,thereci
pientshallretur
nt he
amountr eceivedfrom t
heNCCAundert hisProgram.

Bysubmi t
ti
ngthisForm, Iam authorizingtheNCCAt ocollectt
heabov einfor
mationt obeused
sol
elyfortheevaluat
ionandpr ocessi ngofmyappl i
cat
ion.Iherebycerti
fythatalli
nformat
ion
gi
venar etr
ueandcor rectandt hatanymi srepr
esent
ati
onand/ ormanifest
ati
onoff raudinthi
s
appl
icati
on shal
lbe a gr ound f ordi sapprovalofmyappl i
cati
on and/ort he fi
l
ing ofthe
administ
rat
iveand/orcri
mi nal
char gesagai nstme.

Thisdeclar
ationisbeingissuedaspartofthesupport
ingdocument
sfortherequestofcash
assi
stancefrom t heNati
onalCommissionforCul
tureandtheArts(NCCA)andf orwhat
ever
l
egaloradmi nist
rati
vepur
poseitmayserve.

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Si
gnat
ureov
erPr
int
edName
May2,
2020

Dat
e

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