CS Form No.

4
Series of 2017

Republic of the Philippines

Department of Education
Schools Division Office of Bataan

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. (NAME OF APPOINTEE) has assumed

the duties and responsibilities as (POSITION TITLE) of (SCHOOL/DISTRICT)
effective _________________.

This certification is issued in connection with the issuance of the

appointment of Ms/Mr. (APPOINTEE’S SURNAME) as (POSITION TITLE).

Done this ____ day of __________ ________ in City of Balanga,

Bataan.

(NAME OF PRINCIPAL)
Position Title

Date: ________________

Attested by:

Roshenar V. Cruz
Administrative Officer IV / HRMO

For submission to CSCFO

201 file within 30 days from the
Admin
COA date of assumption of the
CSC appointee