Republic of the Philippines

DEPARTMENT OF EDUCATION
NCR
SCHOOLS DIVISION OFFICE QUEZON CITY

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, ____________________________________, Filipino, of legal age, with permanent

address at __________________________________________________, after being sworn in
accordance with law, hereby depose and state that:

1. I am applying for ____________________ at

Position
______________________________________,
Name of School

_____________________________________________;
Address of School

2. I have submitted the following documents:

2.1 CSC Form 212 (revised 2005) in two copies with the latest
2x2 ID picture
2.2 Certified photocopy of PRC professional identification card
2.3 Certified photocopy of ratings obtained in the Professional
Board Examination for Teachers
2.4 Certified copy of transcript of records
2.5 Copies of service record / certificate of employment
2.6 Certificates of specialized trainings
2.7 Certified copy of Voter’s ID and /or any proof of residency
2.8 NBI Clearance

3. I am executing this Certification to attest to the authenticity and veracity

of all documents submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity

of Documents, I hereby authorize the Department of Education, Division of
_____________, to verify the authenticity of the abovementioned documents.

__________________________
Signature over printed name

__________________________
Date

SUBSCRIBED AND SWORN to before me in City / Municipality ________________ this

_____ day of __________, 2017, affiant exhibiting to me his/her Community Tax
Certificate No. ________ issued on ______________ at ________________, Philippines.

__________________________
 Notary Public

Republic of the Philippines

DEPARTMENT OF EDUCATION
NCR
SCHOOLS DIVISION OFFICE QUEZON CITY

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, ____________________________________, Filipino, of legal age, with permanent

address at __________________________________________________, after being sworn in
accordance with law, hereby depose and state that:

1. I am applying for ____________________ at

Position
______________________________________,
Name of School

_____________________________________________;
Address of School

2. I have submitted the following documents:

2.1 CSC Form 212 (revised 2017) in two copies with the latest
2x2 ID picture
2.2 Certified photocopy of PRC professional identification card
2.3 Certified photocopy of ratings obtained in the Professional
Board Examination for Teachers
2.4 Certified copy of transcript of records
2.5 Copies of service record / certificate of employment
2.6 Certificates of specialized trainings
2.7 Certified copy of Voter’s ID and /or any proof of residency
2.8 NBI Clearance

3. I am executing this Certification to attest to the authenticity and veracity

of all documents submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity

of Documents, I hereby authorize the Department of Education, Division of
_____________, to verify the authenticity of the abovementioned documents.

__________________________
Signature over printed name

__________________________
Date

SUBSCRIBED AND SWORN to before me in City / Municipality ________________ this

_____ day of __________, 2017, affiant exhibiting to me his/her Community Tax
Certificate No. ________ issued on ______________ at ________________, Philippines.
__________________________
Notary Public