I declare and certify that the information that I will submit in the FOI form is true, complete and correct. I am aware that giving false or misleading information or using forged documents is a criminal offense. I bind myself and my principal to use the requested information only for the specific purpose stated and subject to such other conditions as may be prescribed by the Bataan General Hospital and Medical Center. I understand that BataanGHMC may collect and use my personal information contained in the request.