Republic of the Philippines

Department of Education
Region III
SCHOOLS DIVISION OF BULACAN
Provincial Capitol Compound, Brgy. Guinhawa, City of Malolos, Bulacan
website: http://bulacandeped.com email: bulacan@deped.gov.ph Tel: (044) 7910256
_________________________________________________________________________________________________________________________

CERTIFICATION

To whom this may come:

The undersigned authorizes the Department of Education (DepEd) Schools

Division of Bulacan, Malolos City, with office address at Provincial Capitol Compound,
Brgy. Guinhawa, City of Malolos, Bulacan, for the lawful processing of my personal
information, sensitive personal information and privileged information pertaining to my
academic credentials presented to prove my educational qualifications and
achievements for verification purposes as the undersigned requesting
reclassification/upgrading/promotion/appointment/for the position of TEACHER 1 in
DepEd Bulacan.

This authority has been given and executed pursuant to Sections 12 (a)
and 13 (a) of Republic Act No. 10173 or the Data Privacy Act of 2012.

Signed this ________________ day of _______________, 2020 at

Malolos, City, Bulacan.

RENANTE S. CRUZ
NAME AND SIGNATURE OF THE DATA SUBJECT

_________________________________________________________________________________________________________________________

ISO 9001:2015 CERTIFIED

Registration Number: DE-50500546 QM15