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Republic of the Philippines)

City of Tacloban City)

AFFIDAVIT

I JOSE L. CABATANA III, of legal age, 26, with postal address at BLK. 22 LOT 20
KASSEL KRISTINA HEIGHTS SUBDIVISION, TACLOBAN CITY after having duly
sworn in accordance with law hereby depose and state:

That I am presently employed in LEYTE NATIONAL HIGH SCHOOL as


SECONDARY SCHOOL TEACHER II;

That I am presently employed in LEYTE NATIONAL HIGH SCHOOL since


AUGUST 24, 2015 or for a period of 3 Years and 6 Months;

That I was designated as coach of the DIVISION OF TACLOBAN CITY;


SECONDARY ARNIS GIRLS who will participate in the 2019 Palarong Pambansa.

That all the athletes records submitted are true and correct to the best of my personal
knowledge;

That all the athletes are not members of the National Team, National Training Pool
and Development Pool receiving monthly stipend/allowance from the Philippine Sports
Commission (PSC);

That all the athletes of DIVISION OF TACLOBAN CITY; SECONDARY ARNIS


GIRLS, who will participate in the 2019 Palarong Pambansa are eligible to play;

That I execute this Affidavit to attest to the authenticity and veracity of all the
documents submitted.

______________________, __________________

__________________
Affiant

SUBSCRIBED and sworn to before me in ______________, this day


____________of month 20___, affiant executing his/her Community Tax Certificate No.
___________, issued at _________ on _____________.

_______________________
Notary Public

Doc. No. _________


Page No.__________
Book No._________
Series of _________

FOR PALARONG PAMBANSA ONLY