Enclosure no. 04 to Division Memorandum No. __________ s.

2021 re: 2021 National Arts Month Celebration

DECLARATION OF ORIGINAL ARTWORK

I,________________________________, the COACH of

_______________________________ do hereby declare that the art piece entitled
“_______________________________________” which I and the above-named
pupil/student have collaboratively made and submitted as an Official Entry to the
PADAYAW DE ARTES, 2021 National Arts Month
_____________________________ competition is an Original Artwork ; and that
neither the whole art piece nor any part of it, was copied, , traced, duplicated (or through any
other means) from any existing artworks, and other print/ Non-print media. This Declaration
is executed in good faith, our own free will and ensures that our participation to the said
Competition does not violate any laws concerning proprietary or copyrights. I (We) further
understand that the Recognition will be forfeited, once there will be a claimant of the Original
Artwork being copied, duplicated, traced, or through other means. The Contest Organizers
and Project Proponents shall not be held liable for any issues or claims that may arise
regarding the Originality of this Artwork.

_______________________________________
Signature Over Printed Name
_____________________________
Date