OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I _________________________________, Filipino of legal age with permanent address

_______________________________________________at under oath, hereby depose and state that:

1. That each of the document submitted is an authentic and original copy or a true and faithful
reproduction of the original complete and that all statements and information provided therein are true
and correct;

2. That I am assuming full responsibility and accountability on the validity and authenticity of the
document submitted;

3. That I am aware that any violation will automatically disqualify me from the search;

4. That I am making these statements as part of the requirement for the 2021 CALABARZON GAWAD
PATNUGOT SEARCH

_________________________
Applicant

SUBSCRIBE AND SWORN to before me this __________ day of _______, 2021, affiant exhibiting to
me his/her Community Tax Certificate No. _____________ issued on _______________ at
______________________, Philippines

__________________________
Notary Public

Until ________________
PTR No. ________________
Date ________________
Place ________________
Tin ________________
Doc. No. _______
Page No. _______
Book No. _______

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