Republic of the Philippines

Department of Education
Region II – Cagayan Valley
Schools Division of Cagayan

Title: ______________________________________________________________________
Learning Area: __________________________ Grade Level: _______________________
Type of Learning Resource: _________________ No. of Pages: ______________________

DECLARATION OF ANTI-PLAGIARISM

1. I, _____________________________________, understand that Plagiarism is the

act of taking and using another’s ideas and works and passing them off as one’s
own. This includes explicitly copying the whole work of another person and/or
using some parts of their work without proper acknowledgement and referencing.

2. I hereby attest to the originality of this manuscript and has cited properly all the
references used. I further commit that all deliverables and the final output
emanating from this activity shall be of original content. I shall use appropriate
citations in referencing other works from various sources.

3. Every effort has been exerted to locate and seek permission to use adapted works
(stories, poems, songs,illustrations, photographs, etc.) from their respective
copyright owners.

4. I understand that violation from this declaration shall be subject to consequences

and shall be dealt with accordingly by the Department of Education and all laws
applicable thereto.

Writer: ___________________________________
Signature: ___________________________________
Date: ___________________________________

Address: Regional Government Center, Carig Sur, Tuguegarao City, 3500

Telephone Nos.: PLDT (078) 377-1065; Globe Landline (078) 255-5317, (078) 255-5318
Email Address: sdo.cagayan@deped.gov.ph
Website: deped-sdocagayan.com.ph