Republic of the Philippines

Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF BAIS CITY
CAMBAGAHAN NATIONAL HIGH SCHOOL
LOMBOY, CAMBAGAHAN, BAIS CITY

(DATE)
SWORN STATEMENT

TO WHOM IT MAY CONCERN:

I hereby certify that all documents submitted are true and correct with
documentary stamp.

MIKEE C. PIÑERO
(Signature over Printed Name)

SUBSCRIBED and SWORN to before me this ___ day of ______________,

2022, affiant exhibit his/her Passport/GSIS/SSS/PRC/Driver’s License/Others:
PRC License with no. 1403621 issued at Cebu City on 12/15/2015.

__________________________
Person Authorized to Administer Oath

________________________
Designation

Address: Lomboy, Cambagahan, Bais City

Contact No.: 09652050211
Email Address: andro.gutib@deped.gov.ph