Republic of the Philippines)

City of ________________)

AFFIDAVIT
I _________________, of legal age, __________________, with postal address
at_________________ after having duly sworn in accordance with law hereby depose
and state:
That I am presently employed
position______________________;

with

the

__________________

as

That I am employed with the __________________ since or for a period of

_______________;
That I was designated as ____________________________ who will participate
in the 20___ Palarong Pambansa at ___________________________;
That I have been coaching since ______________;
That all the athletes records submitted are true and correct to the best of my
knowledge;
That I attest to the authenticity of all the documents submitted.

__________________
Affiant/Coach

SUBSCRIBED and sworn to before me in ______________, this day

____________of month 20___, affiant executing his/her Community Tax Certificate No.
___________, issued at _________ on _____________.
_______________________
Notary Public

Doc. No. _________

Page No.__________
Book No._________
Series of _________