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Republic of the Philippines

Department of Education
Region vii, central visayas
SCHOOLS DIVISION OF CEBU PROVINCE
BATERIA NATIONAL HIGH SCHOOL

PARENTS’/GUARDIANS’ CERTIFICATION OF WAIVER


for NON-SUBMISSION OF PSA CERTIFICATE

To whom it may concern,

As school policy since the start of the year, I, _____________________________ the


(Name of parent)
parent of ________________________________ Grade & Section _______________________
(Name of learner) (Grade and Section)
S.Y. 2020-2021 was already reminded and urged on the submission of a Philippine Statistics
Authority (PSA) released birth certificate. I was well-informed of its importance since it provides
relevant and accurate information on the personal data of our son/daughter.

However, due to some circumstances, we have not yet submitted the said document. With
this, we shall not be held the school liable in any correction/error in our son/daughter’s
credentials upon the procurement of the said file.

_______________________________________ __________________
Signature over Printed Name of Parent/Guardian Date Signed

Bateria, Daanbantayan, Cebu

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