Republic of the Philippines

Department of Education
REGION V
SCHOOLS DIVISION OF MASBATE PROVINCE

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) S.S.

AFFIDAVIT

I, ___________________________________________________________(name of affiant, civil status, nationality)

After having been duly sworn in accordance with law, do hereby depose and state that:

1. Each of the documents submitted in satisfaction of the hiring guidelines for Teacher I position is an authentic copy of
the original, complete and all statements and information provided therein are true and correct;

2. I am authorizing the members of the School Screening, Division Deputized Selection and Division Selection
Committees or their duly authorized representative(s) to verify and validate all the documents submitted as to their
completeness, veracity, accuracy and authenticity;

3. I am aware of and have undertaken the following responsibilities as a teacher-applicant:

a. Carefully prepare all of the documents required in support of my application to ensure their completeness
and the correctness of the information found therein;
b. Assume full accountability on the validity and authenticity of the submitted documents and any violation will
automatically disqualify me from the selection process.

IN WITNESS THEREOF, I have hereunto set my hand this_______ day of ______________________________2020 at

____________________, Philippines.

___________________________________
Teacher-Applicant

SUBCRIBE AND SWORN to before me this ______ day of ________________________________________ 2020 at

_____________________, Philippines. Affiant exhibiting to me his/her CTC No. __________________________________
issued on ________________ at ________________.

___________________________________
Person Administering Oath

Doc. No. __________:

Page No.__________:
Book No.__________:
Series of 2020

Address: Rodeo Road, Brgy. Centro, Masbate City

Telephone No.: (056) 578-2544
Website: http://Depedmasbate.ph