ANNEX D

REPUBLIC OF THE PHILIPPINES)

(PLACE)S.S

CERTIFICATION ON PAYMENT OF TRAINING SUPPORT FUND

I, (Trainer) and (Name Of School Administrator) of (Name of School) with office address
at (Address) , after having been duly sworn to in accordance with, do herein depose and state
that the attached list of learners/scholars have engaged in the training program and are entitled
to receive the Training Support Fund (TSF).
IN WITNESS WHEREOF, I have hereto set my hand this ______ day of
_____________ 20____.

______________ ________________
Trainer School Administrator

SUBSCRIBE AND SWORN TO before me in ________________________ this

__________________________ affiant exhibiting to me his/her
_____________(Government ID) with ID number __________________.

Doc. No. _________ :

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