Republic of the Philippines)

City of __LA CARLOTA_________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

I, ELMER C. GELSANA., of legal age, Married, with postal

address at Brgy. HAGUIMIT, LA CARLOTA CITY, after having duly
sworn in accordance with law hereby deposes and state:
That I am presently employed in the Haguimit Elem. School – 1,
Division of La Carlota, La Carlota City as Teacher;

That I have been employed in Haguimit Elem. School – 1 since

November 8, 2008 or for a period of 15 Year and 4 months;

That I was designated as coach of FOOTBALL Elementary , who

will participate in the PROVINCIAL MEET of the Department of
Education up to 2024 Palarong Pambansa;

That I will perform my duties and responsibilities in accordance

with DepEd Rules and Policies for the benefit of the students athletes
under my care and custody.
That all the athletes are not members of the National Team,
National Training Pool, and Development Pool of the Philippine Sports
Commission (PSC);
That all the athletes records submitted are true and correct to
the best of my personal knowledge;
Further, I authorize the personnel of Department of Education
to collect, process, retain, and dispose of my personal information in
accordance with the Data Privacy Act of 2012.
That I execute this Affidavit to attest to the authenticity and
veracity of all the documents submitted.
IN WITNESS WHEREOF, I have hereunto set my hand this 18 TH
day of March 2024 in La Carlota City, Philippines.

ELMER C. GELSANA
Affiant

SUBSCRIBED and sworn to before me in ______________, this day

____________of month 20___, affiant executing his/her ____________
___________, issued at _________ on _____________.

_________________________
Notary Public

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Republic of the Philippines)
City of __LA CARLOTA_________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

I, ZYROS JHUN P. LEONES., of legal age, Married, with postal

address at Brgy. HAGUIMIT, LA CARLOTA CITY, after having duly
sworn in accordance with law hereby deposes and state:
That I am presently employed in the Haguimit Elem. School – 1,
Division of La Carlota, La Carlota City as Teacher;

That I have been employed in the DEPED since December 14,

2009 or for a period of 14 Year and 3 months;

That I was designated as Asst. coach of FOOTBALL Elementary

, who will participate in the PROVINCIAL MEET of the Department of
Education up to 2024 Palarong Pambansa;

That I will perform my duties and responsibilities in accordance

with DepEd Rules and Policies for the benefit of the students athletes
under my care and custody.
That all the athletes are not members of the National Team,
National Training Pool, and Development Pool of the Philippine Sports
Commission (PSC);
That all the athletes records submitted are true and correct to
the best of my personal knowledge;
Further, I authorize the personnel of Department of Education
to collect, process, retain, and dispose of my personal information in
accordance with the Data Privacy Act of 2012.
That I execute this Affidavit to attest to the authenticity and
veracity of all the documents submitted.
IN WITNESS WHEREOF, I have hereunto set my hand this 18 TH
day of March 2024 in La Carlota City, Philippines.

ZYROS JHUN P. LEONES

Affiant

SUBSCRIBED and sworn to before me in ______________, this day

____________of month 20___, affiant executing his/her ____________
___________, issued at _________ on _____________.

_________________________
Notary Public

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)