Scribd
Upload
515 views1 page

CEM Annex F Sworn Statement

1. Rey V. Florito worked as an Electrical Maintenance Supervisor for Specialty Pulp Manufacturing Inc. from October 9, 2017 to present. 2. He is submitting a sworn statement to attest to the truth of his employment details to support his application for Certified Energy Manager with the Department of Energy. 3. He signed the sworn statement on November 23, 2022 in Specialty Pulp Manufacturing Plant.

Uploaded by

rey
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
515 views1 page

CEM Annex F Sworn Statement

1. Rey V. Florito worked as an Electrical Maintenance Supervisor for Specialty Pulp Manufacturing Inc. from October 9, 2017 to present. 2. He is submitting a sworn statement to attest to the truth of his employment details to support his application for Certified Energy Manager with the Department of Energy. 3. He signed the sworn statement on November 23, 2022 in Specialty Pulp Manufacturing Plant.

Uploaded by

rey
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

EUMB - EPMPD Doc Ref No.

: EUMB-EPMPD-CEM

Quality Management System Effective Date:

Revision No.: 0
SWORN STATEMENT
(ANNEX F) Page No.: 1 of 1

REY V. FLROTIO
I, _____________________________, of legal age, single/married, Filipino,
with residence and postal address at
BRGY. STO NINO, KANANGA LEYTE
___________________________________________________________________,
after having been duly sworn to in accordance with law, hereby depose and state that:

SPECIALTY PULP MANUFACTURING INC.,


1. That I worked for ________________________________________
ELECTRICAL MAINTENANCE SUPERVISOR
as a ______________________________________________ from
OCTOBER 9, 2017 PRESENT
____________________ up to ___________________, as evidence
thereof I have hereto attached a copy of my Employment Certificate
NOVEMBER 23, 2022
issued by said company dated ___________________ as Annex “A”
and my detailed duties and responsibilities as Annex “B”;

2. That, I am executing this Sworn Statement to attest to the truth of the


foregoing statement and for my application for Certified Energy
Manager (CEM) with the Department of Energy (DOE), Energy
Utilization Management Bureau (EUMB) and undertaking under pain
of administrative, criminal and civil liabilities, and for whatever legal
purpose it may serve.

23
IN WITNESS WHEREOF, I am affixing my signature this _______ day of
NOVEMBER 22 SPECIALTY PULP MANUFACTURING PLANT
_____________________ 20____ in ___________________________________.

___________________________
REY V. FLORITO
Candidate

Reproduction of this Document is not allowed, unless approved by the DOE-EUMB Office of the Director

You might also like