Republic of the Philippines)

City of ________________)

AFFIDAVIT

I Glenn T. Sombero , of legal age, 37 , with postal address at Brgy.

Purisima, Manapla, Negros Occidental after having duly sworn in accordance with law
hereby depose and state:

That I am presently employed in Manapla National High School-Purisima Extension

as Secondary Teacher ;

That I am presently employed in Manapla National High School-Purisima Extension

since July 3,2017 or for a period of 1 year and 4 months ;

That I was designated as coach of the Sepak Takraw; Secondary Boys who will
participate in the 2018 Palarong MACASA Area II at Cadiz City.

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 Sepak Takraw; Secondary Boys, who will participate in the
2018 Palarong MACASA Area II are eligible to play;

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

______________________, __________________

Glenn T. Sombero
Affiant

SUBSCRIBED and sworn to before me this________day of___________ 20___,

affiant executing his/her Government Issued ID/SSS/PRC/Philhealth etc. ___________,
issued at _________ on _____________.

_______________________
Notary Public

Doc. No. _________

Page No.__________
Book No._________
Series of _________

FOR PALARONG PAMBANSA ONLY

FOR PALARONG PAMBANSA ONLY