eee eee case wae t canna [McNeil WRC can EES ae MucHAEL MARL canna [MICHAEL MARE CANNoasrov4CERTIFICATE OF CONSENT \ MICHAEL MARC LASRA_CANANA , a Filipino citizen, er ae 1 a, aa Name, Baenion Nae Fang of legal age, and a resident of ©-1_@2GY MALONG CaTe@ALoGhn cmY, SAMAR, ‘Gone ss) hereby, declare that: 1. | understand that the Civil Service Commission (CSC) is conducting the CSE-PPT PROFESSIONAL on _swxe 9, 2022 Tite oT Exarinton) ‘Dae of Examination) 2. 1am participating in said examination as an Examinee. 3. 1am fully aware of the continuing existence of the Corona Virus Disease (COVID-19) and its potential health threats/risks. 4. | understand that all known precautions and health safety protocols, in accordance with the Omnibus Guidelines of the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases, to ensure my safety are taken/instituted by the CSC in and for the conduct of the examination. 5. | understand that it is my responsibility to comply with the required precautionary measures such as, but not limited to, submission of a duly and truthfully accomplished Health Declaration Form, wearing of face mask and face shield, hand sanitizing as often as possible, physical distancing, and observance of the RT-PCR Testing and Quarantine Protocol as may be applicable in my case. 6. | understand that, despite taking all known precautions and health safety protocols, exposure to COVID-19 is an ever-present risk for which my absolute safety or protection from potential contracting of the virus in the conduct of the examination is ot and cannot be quaranteed. With my full knowledge and understanding of the above declarations, | hereby wholly give my consent and confirm my participation on my own free will and volition in the conduct of the CSE -PPT_ PROFESSIONAL, On _spe 14, 2022 ‘ite a Examination) ‘Tate of Examination) Accordingly, | set CSC entirely free from any liability or responsibility in the event that | contract COVID-19 during the period of the aforementioned examination. se PACMARL ot CANAYA O4-\2- 20n. Signature over printed full name of examinee/examiner Date Signature over printed full name of witness (CSC Verifier) DatePage 1 of 1, 1 Copy (Copy te 0281, ow eecplwd ewcnree)] —_REMARKS/ARNOTATION iV bu TA ji OFFICE OF THE GML REGISTRAR GENERAL CERTIFICATE OF LIVE BIRTH iy AMA ras aw be (29 94 moa, sui aa mpi eo wa. a a td Profey Leet eeee eee cric erat Cty nteispaity _ CATRLEOAT. No! re 35> 1790 7 ANE fo OEE waa) oy TAA camer 2 Sex Xs wy 8 ante DATE OF BAT wa) wane EN Gn er BIRTH howe, PLAGE OF pioneer teipa/cewsa! (ehacray Pees) om ‘SAAR PROVENSIAL —_WOSPETAL ‘IF MULTIPLE BIRTH, CHILD WAS BnEaof carey ee BTW ORDER five Bins sa athe ricdnginscatven) conde) ‘aaze) BACAR at, eo san WEIGHT AT BATH 205 bye ome ta Lama 7 GIVZENSHP on gpnuy yates "BEST POSSIBLE WANN 74250598642500. 6x900989809 18, DATE AND PLAGE OF WAAR honoiedgentinvanot Potent ababick) 0, OCCUPATION |___ 0 ENPLE TE RESIOENCE (hewseho, Sven turrgah ——RPARAROH—_—Proine) ____ Hats wivians Apa ue | | NAME We i) ta fi caw. cismo on [ie GNZENSHP Fino [is REUGION AG | H £ [yay oacuearion 7, tgs shen E hat ST an IAGE OF PARENTS cenat maria seamen oh UIE 28, 1990. catbslogen » sansx Tae. ATTENDANT ryan a ee 3 Monte EE Herston manny 5 hha erect em CERTIACATION OF BiaTH es Than cony ta eines Raber nee waebam shes! 55 aye vem on te dn sed oe CATR. Sie H ~95966-0F-4251B0-00097-81007 | QE E HUN 1705022018001 CLERK I ‘Tne oc Positon 2. RECEIVED AT THE OFFICE OF THE CIVIL REGISTRAR pallial Wu faa Arac /. Pervealor LISA GRACE S. BERSALES, Ph.D. National Staistcian and Givi Registrar General Philippine Statistics Authority (OOM TE ANA BReN (06005-A95W301-9 Documentary ‘Stamp Tax Paid| COVID-19 Vaccination Card mee! MicHABL MARC __L aera a 4a1u] Sinovac. 8 er tw ‘nonrarnee_t Heath Oice Cathal