OMNIBUS SWORN CERTIFICATION

REPUBLIC ACT OF THE PHILIPPINES PROVINCE OF

_______________________________________

I _________________________________, Filipino, of legal age, designated as ___________________ of

__________________________ with registered address located at ___________________________________ do
certify the following:

 The FCAs has authorized the application for accreditation and has authorized the person
actually filing the application to represent the FCAs in the application.
 All supporting documents are authentic, true and correct.
 Neither the FCAs nor any of its member/members has been blacklisted by any GA.
 None of the members of the FCAs has been convicted in any case, or is currently a
defendant/accused/respondent in any pending case, related to the use of public funds.
 The FCAs is aware of, understands, and agrees to abide by the guidelines for
accreditation of FCAs as beneficiary of RCEF.

I HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE FOREGOING

ATTESTATIONS ARE TRUE AND CORRECT.

_____________________________________________

Designation

Date: ______________

SUBSCRIBE AND SWORN to before me this ____ day of ____ 2020, affiant has satisfactorily
proven his identity to me through his valid Identification No. _______________________, with his/ her
picture and signature appearing therein. That he/ she personally swears that he/ she is the
same person who personally signed the foregoing Sworn Certification before me and
acknowledged that he/ she executed the same.

Doc. No. _____;

Page No. _____; Book
No. _____; Series of
2020.