APPOINTMENT DATE: Jan 15, 2020 (05:00 PM TO 06:00 PM) - Robinsons Place, Otis (Secondary)

REFERENCE NO: INYMFFYGYF2J | OR: - | AMOUNT: PHP -

NOT FOR SALE (REPRODUCTION IS ALLOWED)

Republic of the Philippines

Professional Regulation Commission
Manila Paste here
your recent
PASSPORT SIZE
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PANUNUMPA NG PROPESYONAL with complete
name tag

FRANCIS CYRINE WAJA TUMBIZ

Ako, si ______________________________________________________________________, ng
_____________________________________________________________________________________
ANTIPOLO, RIZAL
(Pook na Sinilangan, Bayan/Lungsod, Probinsya)
ay taimtim na nanunumpa na itataguyod ko at ipagtatanggol ang Saligang Batas ng Pilipinas, na ako ay
tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at mga atas na
ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas; at kusa kong
babalikatin ang pananagutang ito, na walang ano mang pasubali o hangaring umiwas.

Taimtim pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay mahigpit

akong manghahawakan sa mga etikal at tuntuning propesyonal ng mga
PROFESSIONAL TEACHER
____________________________ sa Pilipinas, at marapat kong gagampanan ng buong husay sa abot ng
(Propesyon)
aking makakaya ang mga tungkulin at pananagutang iniatang sa isang itinakdang
PROFESSIONAL TEACHER
________________________.
(Propesyon)

Kasihan Nawa ako ng Diyos.

______________________________________
( Lagda)
741-531-740-000
A - ____________________________ BUREAU OF INTERNAL REVENUE _________________________
_______________________ Apr 17, 2019
(Blg. Ng Sedula) (Kinuha sa) (Petsa)

Nilagdaan at Pinanumpaan sa harap ko ngayong ika-____________ ng ________________________

taon ng ating Panginoon _____________________ sa ___________________________, Pilipinas.

FOR PRC PROCESSING

-
OK to Pay: __________________________________ __________________________________
Selyo -
OR No.: _____________________________________ (Pinunong Tagapanumpa)
Dokumentaryo -
Date Paid: ___________________________________
PROFESSIONAL TEACHER
Profession: __________________________________ __________________________________
Registration No.: ______________________________ (Katungkulang Opisyal)
Registration Date: _____________________________

PERSONAL DATA
Telephone/Contact Number: 09389746990 Date of Examination: Sep 01, 2019
Citizenship: FILIPINO Date of Birth: Aug 24, 1998
Civil Status: SINGLE Sex: MALE Spouse’s Name/Citizenship:
Father’s Name/Citizenship: FRANKLIN H. TUMBIZ / FILIPINO Mother’s Name/Citizenship: SITTI JABIRA W. TUMBIZ / FILIPINO

PLEASE FILL OUT THIS CLAIM SLIP

CLAIM SLIP

FRANCIS CYRINE WAJA TUMBIZ

NAME: _______________________________________ PROFESSIONAL TEACHER
PROFESSION: _________________________________
REGISTRATION NO. ____________________________ REGISTRATION DATE: __________________________
Please present this slip at Issuance Window ____________________ to claim your professional identification card on
________________________.
(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY/ AUTHORIZATION
LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.

____________________________________________
(Registration Officer)

REG- 01
Rev. 00
February 25, 2015
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