REPUBLIC OF THE PHILIPPINES)

CITY OF PAGADIAN. . . . . . . ) S.S.

X------------------------------------)

AFFIDAVIT OF LATE SUBMISSION OF GRADES

I, JOSEPH BAYANI SALIMBANGON, of legal age, single a resident of Barangay Lumbia, Pagadian
city, after having been duly sworn to in accordance with law, hereby depose and says:

1. That I am presently a Guest Lecturer of the Western Mindanao State University; External
Studies Unit Pagadian City;

2. That during the first semester of School Year 2016 - 2017, I handled Class with the subjects
PE 103 (INDIVIDUAL AND DUAL SPORTS) schedule every 7:00-9:00 of SAT , PE 101
(PHYSICAL FITNESS ACTIVITIES) schedule every 10:00-12:00 of SAT, and HIST 100 (Rizal:
Life, Works & Writings) schedule every 2:00 5:00 of SUN of the said school;

3. That during that semester, the said report of ratings of the above mentioned subjects
were not submitted on the scheduled date due to my health conditions;

4. That I am executing this affidavit freely and voluntarily based on my personal knowledge in
order to attest the truth of the foregoing facts and circumstances.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of January 2017, at Pagadian City,
Philippines.

JOSEPH BAYANI SALIMBANGON

Affiant

Subscribed and sworn to before me this 5 TH day of January 2017, at Pagadian City, Philippines.
Affiant exhibited to me his valid No. 1283895 issued by Professional Regulation Commission on
June 3, 2014, as his competent evidence of identity.