OMNIBUS SWORN CERTIFICATION

REPUBLIC ACT OF THE PHILIPPINES

PROVINCE OF

I (name) , Filipino, of legal age, designated as ____(position)____

of (name of organization) an FCA with registration no.______________ located at
(Brgy/Municipality/Province) do certify the following:

 The FCA has authorized the application for accreditation and has authorized the
person actually filing the application to represent the FCA in the application.
 All supporting documents are authentic, true and correct.
 Neither the FCA nor any of its member/members has been blacklisted by any GA.
 None of the members of the FCA 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 FCA is aware of, understands, and agrees to abide by the guidelines for
accreditation of FCA as beneficiary of RCEF.

I HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE FOREGOING

ATTESTATIONS ARE TRUE AND CORRECT.

_(Signature Over Printed Name)

Designation

Date:

SUBSCRIBE AND SWORN to before me this day of 2019, 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 2019.