ANNEX 3: Declaration of Absence of Conflict of Interest

DECLARATION OF ABSENCE OF CONFLICT OF INTEREST

1. We, Frances A. Palec, Jeryl B. Balajadia, and Arlie B. Balayo, understand

that conflict of interest refers to situations in which financial or other personal
considerations may compromise my judgment in evaluating, conducting, or
reporting research.

2. We hereby declare that we do not have any personal conflict of interest that
may arise from our application and submission of our research proposal. We
understand that our research proposal may be returned to us if found out that there
is conflict of interest during the initial screening as per DepEd Order No. 16, s.
2017.

3. Further, in case of any form of conflict of interest (possible or actual) which

may inadvertently emerge during the conduct of our research, we will duly report it
to the research committee for immediate action.

4. We understand that we may be held accountable by the Department of

Education and Basic Education Research Fund for any conflict of interest which we
have intentionally concealed.

Proponent 1 Printed Name: ____________________________________

Signature:__________________________________

Date Signed: ____________________

Proponent 2 Printed Name: ____________________________________
Signature:__________________________________

Date Signed: ____________________

Proponent 3 Printed Name: ____________________________________
Signature:__________________________________
Date Signed: ____________________

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph