Revised as of September 26, 2019

Republic of the Philippines)

City of ___________________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

I MICHAEL JORDAN D. ABRAGAN, of legal age, single/married,

with postal address at PUROK 11, POBLACION, INITAO, MISAMIS
ORIENTAL, after having duly sworn in accordance with law hereby
depose and state:

That I am presently employed with the DEpED-INITAO SOUTH

INITAO CENTRAL SCHOOL as TEACHER I;

That I have been employed in INITAO CENTRAL SCHOOL since

NOVEMBER 5, 2018 or for a period of 5 YEARS AND 2 MONTHS;

That I was designated as coach of ARNIS, 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 15th

day of JANUARY, 2024 in INITAO, MISAMIS ORIENTAL, Philippines.

MICHAEL JORDAN D. ABRAGAN

Affiant

SUBSCRIBED and sworn to before me in 15th DAY of JANUARY, 2024, affiant

executing his/her PRC.

_________________________
Notary Public

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)