Republic of the Philippines)

SAN CARLOS
City of ________________)

AFFIDAVIT
ARMANDO S.
32
I VINOYA,
_______________________,
of legal age, __________________,
with postal
# 75 Longos-Pagal, San Carlos City, Pangasinan after having duly sworn in
address at__________________________________________
accordance with law hereby depose and state:
II Elementary School
Head Teacher III ;
That I am presently employed inCentral
_______________________as
________________
Central II Elementary School
January 08, 2007
That I am presently employed in ______________________
since _______________
8
years
and
8
days
or for a period of _______________;
Volleyball Boys Secondary
That I was designated as coach of the _____________________________;
____________________ who will participate in the 20___ Division, Region and Palarong
Pambansa.

That all the athletes records submitted are true and correct to the best of my personal
knowledge;
That all the athletes are not members of the National Team, National Training Pool
and Development Pool receiving monthly stipend/allowance from the Philippine Sports
Commission (PSC);
Volleyball Boys Secondary
That all the athletes of _____________________________________,
____________
______________, who will participate in the 20___ Division, Region and Palarong
Pambansa are eligible to play;

That I execute this Affidavit to attest to the authenticity and veracity of all the
documents submitted.
______________________, __________________
__________________
Affiant
5th
SUBSCRIBED AND SWORN TO before me this ________day
of
SAN CARLOS CITY, PANGASINAN
JANUARY
15
_________________, 20__ in ____________________________________, affiant
exhibiting
me
his/her
Community
Tax 05,
Certificate
No.
21547821 to
JANUARY
2015
SAN CARLOS CITY, PANGASINAN
______________________,
issued
on
______________________
in
_______________________________________.
_______________________
Notary Public
Doc. No. _________
Page No.__________
Book No._________

Series of _________