REPUBLIC OF THE PHILIPPINES …...

)
IN THE MUNICIPALITY OF MOLAVE……) S.S
X…………………………………………..…/

OMNIBUS CERTIFICATION

I, _____________________, of legal age, Filipino, single and a resident of

________________________________, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say:

That I am applying as a Senior High School Teacher at

___________________________________;
That I hereby certify that the following documents contained in my application are
true, correct and faithful reproduction of the original which are in my possession, to wit;

a.) CSC Form 212 (Revised 2017)

b.) Certified copy of Transcript of Records (Graduate Studies & College);
c.) Certificate of General Weighted Average (GWA) (both Graduate Studies &
College)
d.) Copies of Service Records
e.) Certificates of specialized training programs attended
f.) Certified copy of the Voter’s ID and/ or any proof of residency
g.) Police Clearance
h.) NBI Clearance

That above-mentioned documents are authenticate copies of the original, complete,

and all information provide therein are true and correct;
I am authorizing school committee or duly authorized representative (s) to verify all
the documents submitted;
Carefully examine all the requirements submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of July 2019,
at _____________________, Philippines.

__________________________
Applicant

SUBSCRIBED AND SWORN TO before me this ___th day of July 2019 affiant is exhibiting
to me her Community Tax Certificate No. ___________ issued on January 04, 2019 issued at
_______________________.

Doc. No. :______

Page No. :______
Book No. :______
Series of :_____