Revised as of April 2023
Republic of the Philippines)
Carmona
City of ___________________)S.S.
OMNIBUS AFFIDAVIT
(for Public and Private Personnel)
AGUSTINE C. CASTILLO
I _______________________________,
of legal age, single/married,
Phase 1 Milagrosa, City of Carmona,
Cavite after
with postal address at___________________________
,
having duly sworn in accordance with law hereby depose and state:
That I am presently employed with the DepEd – Division of Cavite
Teacher III
Province
as _______________________;
Carmona Elementary School
That I have been employed in ______________________________
February
12,
2013
10 years and 10 months;
since _____________________or for a period of _______________
Athletics
That I was designated as coach of _______________________,
who
will participate in the School Sports activities 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
November
City of Carmona, Cavite
5
_______
day of _____________________2023
in ________________________,
Philippines.
th
__________________________
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)