Omnibus Affidavit

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Revised as of April 3, 2023

Republic of the Philippines)


City of ___________________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

I CHERISH L. CONVICTO, of legal age, single/married, with


postal address at BRGY. 04, MARIA AURORA, AURORA ,after having
duly sworn in accordance with law hereby depose and state:

That I am presently employed with the DEPARTMENT OF


EDUCATION as T-III;

That I have been employed in RAMADA NHS since JUNE 05,


2017 or for a period of 6 years;

That I was designated as assistant coach of VOLLEYBALL


SECONDARY 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


_______ day of _____________________20__ in ________________________,
Philippines.

__________________________
Affiant

SUBSCRIBED and sworn to before me in ______________, this day


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

_________________________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


Notary Public

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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