Revised as of February 2024

Republic of the Philippines)

Province of ________)S.S.
Bohol
OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

RODEL A. ASILO
I _______________________________, of legal age, single/married,
with postal address at___________________________
CANHAWAY, GUINDULMAN, BOHOL ,after having duly
sworn in accordance with law hereby depose and state:
DEPED
That I am presently employed with the __________________ as
TEACHER III
_______________________;

DEPED
That I have been employed in ______________________________
DECEMBER 15, 1999
since _____________________or for a period of 24 YEARS AND 3 MONTHS ;

That I was designated as assistant coach of

BASKETBALL ELEM BOYS 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
MARCH
20TH day of _____________________2024
_______ in CANHAWAY,
________________________,
GUINDULMAN, BOHOL
Philippines.

RODEL A. ASILO
__________________________
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)