SWORN DECLARATION of PERSONALLY TAKING A J3TCI ONLINE COURSE |, POLICRONIG C. FABILLAR tH, Filipino, of legal ege, single/merried, permanently residing at ACACIA ST,, BRGY. PANGATIAN, CABANATUAN CITY, NUEVAECUA, and working at R. NADORA ‘TRAINING CENTER INC. with address at PUROK GUUG, BRGY. LOURDES, CABANATUAN CITY, NUEVA ECUA after having been sworn in accordance with law hereby depose and declare that: + have personally taken the online course at the 13 Trainers and Consultants online training platform, # / BOSH for S02 7 / BOSH (40-HOURS) 7 # COSH (40-HOURS) f / BOSH for the Public Sectur «have taken the quizzes and final examination without help from others. «duly execute this SWORN GECLARATION in comp he requirement issued by the Occupational Safety and Health Center of the Department of Labor and Employment {DOLE} as proof that the course was personally taken by me and the examinations without help from others. ice with + | declare under penalty of perjury, that this declaration has ween made in good faith and to the best of my knowledge and belief to be true and correct. IN WITNESS WHEREOF, | have unto set my hand this 23 day of September, 2022 at suicseog Ee eee IT (Signature aver printed name of enroliee} SUBSCRIBED AND SWORN to before me this day of, mO in Enrollee exhibited to me his/her issued at at, on. Doc. Wo. Poge No, Book No. Series of