Omnibus-Affidavit v2023 Editable

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Revised as of April 2023

Republic of the Philippines)


Cebu
City of ___________________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

RAYNIZA THERESE P. MABINI of legal age, single/married,


I _______________________________,
with postal address at___________________________
BINALIW NATIONAL HIGH SCHOOL BINALIW, CEBU CITY ,after having duly

sworn in accordance with law hereby depose and state:

That I am presently employed with the DEPARTMENT


__________________
OF EDUCATION as
REGULAR PERMANENT TEACHER
_______________________;
BINALIW NATIONAL HIGH SCHOOL
That I have been employed in ______________________________
AUGUST 14, 2012
since _____________________or 11 YEARS
for a period of _______________;
VOLLEYBALL BOYS - SECONDARY
That I was designated as coach of _______________________, who
will participate in the School Sports activities of the Department of
Education up to 20__ 24 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


_______ OCTOBER
15TH day of _____________________2024 in ________________________,
CEBU CITY
Philippines.

__________________________
RAYNIZA THERESE P. MABINI
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)


Revised as of April 2023

Republic of the Philippines)


Cebu
City of ___________________)S.S.

OMNIBUS AFFIDAVIT
(for Public and Private Personnel)

MARIA MELANIE A. DIONSON of legal age, single/married,


I _______________________________,
with postal address at___________________________
BINALIW NATIONAL HIGH SCHOOL BINALIW, CEBU CITY ,after having duly

sworn in accordance with law hereby depose and state:

That I am presently employed with the DEPARTMENT


__________________
OF EDUCATION as
REGULAR PERMANENT TEACHER
_______________________;
BINALIW NATIONAL HIGH SCHOOL
That I have been employed in ______________________________
NOVEMBER 10, 2014
since _____________________or 9 YEARS
for a period of _______________;
VOLLEYBALL GIRLS - SECONDARY
That I was designated as coach of _______________________, who
will participate in the School Sports activities of the Department of
Education up to 20__ 24 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


_______ OCTOBER
15TH day of _____________________2024 in ________________________,
CEBU CITY
Philippines.

__________________________
MARIA MELANIE A. DIONSON
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)

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