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Republic of the Philippines

Department of Education
Region V
SCHOOLS DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES


CITY OF MASBATE

AFFIDAVIT

I, JERRY R. ABSALON JR., single, Filipino, (name of affiant, civil status, nationality), after having
been duly sworn in accordance with the law, do hereby depose and state that:

1. Each of the documents submitted in satisfaction of the hiring guidelines for teacher I position is
an authentic of the original, complete and all statements and information provided therein are true and
correct;

2. I am authorizing the members of the School Screening, Division Deputized Selection and
Division Selection Committees or their duly authorized representative(s) to verify and validate all the
documents submitted as to their completeness, veracity, accuracy, and authenticity;

3. I am aware of and have undertaken the following responsibilities as a teacher-applicant:

a. Carefully prepare all of the documents required in support of my application to ensure


their completeness and the correctness of the information found therein,

b. Assume full accountability on the validity and authenticity of the submitted documents
and any violation will automatically disqualify me from the selection process.

IN WITNESS THEREOF, I have hereunto set my hands this _________ day of ________________________
2019 at _______________________________, Philippines.

_______________________________
Teacher-Applicant

SUBSCRIBE AND SWORN to before me this _____________ day of ____________________________


2019 at
_______________________________, Philippines. Affiant exhibiting to me his/her CTC No. ____________
issued on _________________________ at ______________________________.

______________________________
Person Administering Oath

Doc. No.: ____________


Book No.: ___________
Page No.: ____________
Series of.: ____________

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