Republic of the Philippines

Department of Education
REGION VIII
SCHOOLS DIVISION OF CATBALOGAN CITY
Office of the Schools Division Superintendent
Enclosure 3 Division Memorandum No. 194, s. 2021

Republic of the Philippines

City of Catbalogan ) S. S.
Province of Samar )

OMNIBUS SWORN STATEMENT

I, Elmer Oblino Abainza, of legal age, Single, Filipino, and residing at Purok 1 Barangay
Canlapwas, Catbalogan City, Samar. After having been duly sworn in accordance with law, do hereby
depose and state that:

1. Each of the documents submitted in satisfaction of my application for teaching position is an

authentic copy of the original, complete and all statement and information provided therein
are true and correct.

2. I am authorizing the selection committee or its duly authorized representative(s) to verify all
documents submitted as to completeness and authenticity.

IN WITHNESS WHEREOF, I have hereto set my hand this _____ day of ______________,
2022 at Catbalogan City, Samar, Philippines.

__________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 2021 in

___________________________. Affiant exhibiting to me his/her valid identification card -
_______________________________ issued by ____________________________ at
______________________________________.

Doc. No. ____________

Book No. ____________
Page No. ____________
Series of ____________

Address: Maharlika Highway, Purok 4, Barangay Payao 6700 Catbalogan, Philippines

Telephone No:
Email Address: catbalogan.division@deped.gov.ph
Facebook Page: DepEd, Schools Division of Catbalogan City