Republic of the Philippines)

City of ___________________)S.S.

SWORN STATEMENT
MARLON S. NARVASA
I _______________________________, of legal age, single/married,
with postal address at_________________________________ ,after having
duly sworn in accordance with law hereby depose and state:
DEPED - OLONGAPO
That I am presently employed with the __________________ as
TEACHER
_______________________;

That I have been employed in DEPED – GORDON HEIGHTS I E/S

______________________________
1998 present
since _____________________or for a period of _______________;

That I was designated as co-coach of VOLLEYBALL ELEM. GIRLS

_______________________,
who will participate in the 2018 Palarong Pambansa;

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);

That all the athletes records submitted are true and correct to
the best of my personal knowledge;
VOLLEYBALL ELEM. GIRLS
That all the athletes of _______________________________, who will
participate in the 2018 Palarong Pambansa are eligible;

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

12th January OLONGAPO CITY
_______ day of _____________________2018 in ________________________,
Philippines.

__________________
Affiant

SUBSCRIBED AND SWORN TO before me this ________day of

_________________, 20__ in _____________________, affiant exhibiting to
me his/her Government issued ID/SSS/PRC/Philhealth, etc.
______________________.

_________________________
Schools Division Superintendent /
Administrative Officer

FOR PALARONG PAMBANSA ONLY