AFFIDAVIT OF CLAIM AND AUTHORITY TO DEDUCT
I, Diana De Venecia, of legal age, Filipino, single, and with address at 1553
Chrysanthemum St. Villa Eusebio San Miguel, Pasig City 1600, after having duly sworn
in accordance with law hereby depose and state that:
1. I am currently employed by Accenture, Inc. (the “Company” or “Accenture”), with
principal office address at 7th Floor Robinsons Cybergate 1, Pioneer St.,
Mandaluyong City.
2. My permanent residence, as reflected in my company records, located at 1553
Chrysanthemum St. Villa Eusebio San Miguel Pasig City 1600, was damaged due
to Typhoon Carina indicated in the state of calamity declaration that occurred
last July 24, 2024.
3. I acknowledge that I need to submit all the required documents needed to support my
Calamity Benefit Claim, including a signed and duly notarized coy of this Affidavit of
Claim and Authority to Deduct, on or before August 2, 2024 or within 45 days from
the date of calamity.
4. If I fail to submit a notarized copy of this Affidavit within 90 days from the date of
calamity, I hereby authorize Accenture to recover the Calamity Benefit that I received
and deduct the same from my payroll.
5. As proof of the damage to my residence I hereby attach a duly issued Barangay
Certificate which reflects my name, address, and the fact that my residence was
indeed damaged by the calamity, as well as photographs that depict the damage to
my residence.
6. The said residence is the same residence I declared to HR as my permanent
residence which appears in my employee file.
7. I understand that I am only entitled to the Calamity Assistance specific to above
mentioned calamity only once. I further represent and warrant that aside from this
claim I have not filed for Calamity Assistance with the Company for the same
incident.
8. I acknowledge that the Company has the right to verify the truthfulness of my claim
and for this purpose. I expressly consent to Accenture, its agents, employees or its
duly authorized representatives to make inquiries, conduct background checks or
any other verification of information regarding my personal information and the
circumstances of my claim.
9. I acknowledge that any misrepresentation(s) in this claim or the submission of any
fake document(s) may lead to disciplinary action up to and including my
termination from employment pursuant to Policy 0093 – Discipline Policy.
10. I am executing this affidavit to attest to the truth of the foregoing and for the purpose
of supporting my claim for Calamity Assistance.
Mandaluyong City, August 02, 2024.
Signature Over Full Printed Name of Employee
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of __________ , 20___, affiant
having shown to me his/her government issued ID No. ______________ issued on
______________at_____________.
Notary Public
