You are on page 1of 2

Revised as of April 3, 2023

Republic of the Philippines)


City of ___________________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

I MR. JOEL VILLANUEVA, of legal age, single/married, with


postal address at #2 Otero Ave., Mabayuhan St. Olongapo, after
having duly sworn in accordance with law hereby depose and state:

That I am presently employed with the IANTHE CHRISTIAN


ACADEMY, INC. as Part time P.E Teacher;

That I have been employed in IANTHE CHRISTIAN ACADEMY,


INC. since August 2019 up to present;

That I was designated as coach of the following students,

1. ALFONSO RAFAEL ACUPAN


2. LIONEL DECASA BASILIO
3. PRINCESS MALANA
4. ALTHEA DOMINIQUE PAREDES

who will participate in the School Sports activities of the Department


of Education up to 2024 Palarong Pambansa;

That I will perform my duties and responsibilities in accordance


with DepEd Rules and Policies for the benefit of the students athletes
under my care and custody.

That all the athletes are not members of the National Team,
National Training Pool, and Development Pool of the Philippine Sports
Commission (PSC);

That all the athletes records submitted are true and correct to
the best of my personal knowledge;

Further, I authorize the personnel of Department of Education


to collect, process, retain, and dispose of my personal information in
accordance with the Data Privacy Act of 2012.

That I execute this Affidavit to attest to the authenticity and


veracity of all the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this


_______ day of _____________________20__ in ________________________,
Philippines.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


JOEL VILLANUEVA
Affiant

SUBSCRIBED and sworn to before me in ______________, this day


____________of month 20___, affiant executing his/her ____________
___________, issued at _________ on __________

_________________________
Notary Public

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

You might also like