OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, (name) Filipino, of legal age, with permanent address at (address), after being
sworn in accordance with law, hereby depose and state that;

I am applying for Teacher I at (school name), (school address).

I have submitted the following documents;

1. CSC Form 212 ( Revised 2005)

2. Certified photocopy of PRC professional identification card
3. Certified photocopy of ratings obtained in Licensure Examination for
Teachers (LET)
4. Certified photocopy of Service Records, Performance Rating and Certificate of
Rating.
5. Certified photocopy of Transcript of records of Specialization in relevant
strand/specialized subject.
6. Certified photocopy of relevant specialized training
7. Certified photocopy of Voter’s id/ or proof of residency
8. NBI Clearance

I am executing this certification to attest to the authenticity of all documents

submitted.

By executing this Omnibus Certification of Authenticity and Veracity of Documents, I

hereby authorize the Department of Education, Division of Marinduque through the
school principal, to verify the authenticity of the above mentioned documents.

__________________________________________
Signature over printed name

_______________________________________
Date

SUBSCRIBE AND SWORN to before me this _________ in

___________________________ , affiant to me his/her CTC No.
_______________________, issued on _____________ at ________________.

Doc No. _________________________

Page No. NOTARY PUBLIC
Book No.
Series No. Until____________________
PTR No._________________
IBP No.___________________