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Omnibus-Affidavit v2024

Sample Omnibus

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24 views1 page

Omnibus-Affidavit v2024

Sample Omnibus

Uploaded by

israfeljutba
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Revised as of February 2024

Republic of the Philippines)


City of ___________________)S.S.
OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

Melvin C. Tabacon
I _______________________________, of legal age, single/married,
with postal address at___________________________ ,after having duly
sworn in accordance with law hereby depose and state:
That I am presently employed with the __________________ as
_______________________;

That I have been employed in ______________________________


since _____________________or for a period of _______________;

Wrestling – Secondary Boys


That I was designated as coach of _______________________, who
will participate in the School Sports activities of the Department of
Education up to 20__24 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
_______ day of _____________________20__ in ________________________,
Philippines.

__________________________
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)

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