HRMPSB FORM NO.

002

Republic of the Philippines)

City/Municipality of _________________________) S.S

AFFIDAVIT

I, ________________________________________________, of legal age, Single/Married/Widower/Widow,

Filipino and residing at ______________________________________________________________, after
having been duly sworn to in accordance with law, do hereby depose and state that:

1. I am an applicant for ___________________________________________, filed application before the

DepEd-Baguio City Division, Military Cut-off, Baguio City;

2. I hereby certify that each of the documents I submitted in support of my application is an

authentic copy and/or faithful reproduction of the original, complete, and all statements and
information provided therein are true and correct;

3. I am authorizing the School Human Resource Merit Promotion and Selection Board or its duly
authorized representative to verify all the documents submitted;

4. I am fully aware that I assume full responsibility and accountability on the validity and
authenticity of the documents I submitted and any misrepresentation will automatically
disqualify me from the selection process; and

5. I have signed each and every page of the documents I submitted on the left margin portion
thereof.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________ day of _______________________
______________ at ___________________________________________________, Philippines.

_____________________________________
(Name and Signature of Affiant)

Republic of the Philippines )

_________________________ ) S.S

SUBSCRIBED AND SWORN TO before me this ____________ day of ______________________ _________

at _____________________________ and identified by me through competent evidence of identity.

Doc. No. ___________:

Page No. ___________: _____________________________________
(Administering Officer)
Book No. ___________:
Series of ____________: