SWORN ACCOUNTABLITY STATEMENT

I, , of legal age, Filipino, married, and with a residence and postal address at
hereby certify that;
1. All information is accurate and complete to the best of our knowledge,
and that an objective and thorough assessment this application was undertaken
in accordance with the dictates of professional and reasonable judgment.
2. Should I learn of any information which would make this application
inaccurate, I shall immediately bring the said information to the attention of the
DENR-EMB.
I further hereby certify that no DENR-EMB personnel was directly involved
in the application and takes full responsibility to answer any penalty that may be
imposed arising from any misrepresentation or failure to state material
information in this application.
In witness whereof, I hereby set my hand this 18 th day of October 2022 at
Baguio City, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this 18th day of October 2022 at

Baguio City, Philippines. Affiant appear personal before me presenting his Driver’s
License bearing a license number