SWORM STATEMENT

I hereby certify under oath that I have actually enrolled in the school or schools listed in

the foregoing transcript of records and that I have actually earned all the units indicated

therein. As required by the Department of Education (Western Visayas) the Regional Office has

been furnished with authentic copies of the sworm statement and its enclosures.

_____________________
Signature

SUBSCRIBED AND SWORM to before me this _____________________ day of

___________________ at Roxas City, affiant exhibiting to me his/her Residence Certificate

No.___29207344___ issued at Tapaz, Capiz on _January 10, 2023____.

MA. LUNIE B. SAMPANI, CPA, MPA_______

OIC-Office of the Asst.Schools Division Superintendent