This sworn statement affirms that the affiant is employed as a coach for a school participating in the upcoming Palarong Pambansa. It states that the affiant has been employed in this position for a specific period of time and was designated as the coach for the school's athletes competing in the 20__ Palarong Pambansa. The affiant further attests that all athlete records and eligibility documents submitted for the event are true and accurate to the best of their knowledge.

1. FOR PALARONG PAMBANSA ONLY
Republic of the Philippines)
City of ___________________)S.S.
SWORN STATEMENT
I _______________________________, of legal age, single/married,
with postal address at___________________________ ,after having duly
sworn in accordance with law hereby depose and state:
That I am presently employed with the __________________ as
_______________________;
That I have been employed in ______________________________
since _____________________or for a period of _______________;
That I was designated as coach of _______________________, who
will participate in the 20__ Palarong Pambansa;
That all the athletes records submitted are true and correct to
the best of my personal knowledge;
That all the athletes of _________________, who will participate in
the 20__ Palarong Pambansa are eligible;
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
_______ day of _____________________20__ in ________________________,
Philippines.
__________________
Affiant
SUBSCRIBED AND SWORN TO before me this ________day of
_________________, 20__ in _____________________, affiant exhibiting to
me his/her Community Tax Certificate No. ______________________,
issued on ______________________ in __________________________.
_________________________
Regional Director/
Schools Division Superintendent

2. FOR PALARONG PAMBANSA ONLY