Republic of the Philippines

Department of Education
Region ___
SCHOOL DIVISION OF ________
_________________________

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES

MASBATE CITY/ MUNICIPALITY OF ___________

AFFIDAVIT
I, ______________________ (name of affiant, civil status, and nationality), after having been
duly sworn in accordance with law, do hereby depose and state that:

1. Each of the documents submitted in satisfaction of the hiring guidelines for Teacher 1 position
is an authentic copy 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 correctness of the information found in 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 to set my hand this ____ day of ________________
2019 at _________________________________________, Philippines.

___________________
Teacher-Applicant

SUBSCRIBED AND SWORN to before me this _____ day of ________________ 2019

at___________________________, Philippines affiant exhibiting to me his/ her Community Tax
Certificate no. ___________________ issued on __________________ at
______________________, Philippines.

__________________________________
Person Administering Oath

Doc No. ______________

Book No. _____________
Page No. _____________
Series of. _____________