Affidavit of Undertaking Covid PDF

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Affidavit of undertaking for Covid-19 cases. Document not mine. Shared publicly by a public office....

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REPUBLI C OFTHE PHI LI PPI NES _ ___ ___ ___ ___CI TY

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AFFI DAVI T OFUNDERTAKI NG I , ( name) ,an appl i cantf or ( pos i t i on appl i edf or ) ,af t erhavi ngbeendul yswor ni naccor dancewi t h l aw,her ebyunder t aket ope r f or mt hef ol l owi ng,i nc onnect i on wi t h myappl i cat i onf ort hepos i t i onof_ ___ ___ ___ __: 1.Ishal li nf or mt heCounci li n wr i t i ngand submi tan updat ed Compr ehensi v e Medi cal Cer t i ficat e shoul d I cont r ac tt he age of t he Cor onavi r us Di sease ( COVI D19) at any st appl i cat i onpr oce ss; 2.Iwi l lsubj ectmyse l ft oaReal Ti mePol ymer aseChai nReact i on ( RTPCR)t est i ng,andi nf or mt heCounci li nwr i t i ngt her esul t s t her e of t oge t her wi t h an updat ed Compr ehensi ve Medi cal Cer t i ficat ei nanyoft hef ol l owi ngcas es:( a)shoul dIexpe r i ence f e ver ,col ds ,cough,sor et hr oat ,s hor t ness ofbr eat h,f at i gue , musc l e and j oi ntpai ns,sneez i ng notr el at ed t o al l er gy ,and ot herCOVI D19r el at ed sympt oms;( b)shoul d Icomei nc l ose cont ac twi t h a known caseofCOVI D19;( c)s houl d Ihav ea r ecent l ocalor f or ei gn t r av elt oa l ocat i on wi t h confir med COVI D19 case; and/or ( d) shoul d I ,i n any manner what soever , cont r act t he COVI D19 at any s t ag e of t he appl i cat i onpr oce ss; 3.Iwi l li nf or mt heCounci li n wr i t i ngt oge t herwi t h an updat ed Compr ehensi v e Medi cal Cer t i ficat e shoul d I cont r act any herser i ousi l l nessesatany COVI D19r el at eddi seaseoranyot st ageoft heappl i cat i onpr ocess . Shoul d Ihave been f ound t o have made f al se st at ement s, mi sr epr e sent at i ons, or conceal ment s r egar di ng my f or egoi ng under t aki ng,Iunder s t and t hatIshal lbe consi der ed di squal i fied f r om be i ngnomi nat edbyt heCounci l . _ ___ ___ ___ ___ ___ ___ ___ __ Affiant SUBSCRI BED and SWORN t o be f or e me t hi s_ __ day of _ ___ ___ ___2020 at_ __ ___ ___ _,byAffiantwho per sonal l y appear ed bef or eme,exhi bi t i ngt ome___ ___ ___ ___ ___ ___ ___ __ _ ___ ___ ___ ___ ___ ....