CERTIFICATION

I, _ ___________________ , of legal age, single , Filipino, and residing at

______________________ __ ___________________________________ , after having
been duly sworn in accordance with law, do hereby depose and state that:

1. Each of the documents submitted in satisfaction of the requirements for Hiring

Teacher I position Based on the Reform Actions in Basic Education Sector Reform Agenda
(BESRA) is an authentic copy of the original, complete, and all statements and information
provided therein are true and correct;

2. I am authorizing the School Selection Committee or its duly authorized

representative(s) to verify all the documents submitted;

3. I am aware of and have undertaken the following responsibilities as a Teacher-

Applicant:

a) Carefully examine all of the requirements for Hiring Teacher I position Based on the Reform
Actions in Basic Education Sector Reform Agenda (BESRA);

b) Acknowledge all conditions in the Revised Guidelines on Hiring Teacher I position Based on
the Reform Actions in Basic Education Sector Reform Agenda (BESRA) “DepEd Order No. 12,
s. 2012;

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of__________ 2017 at
__________________________, Philippines.

____________________________ _________
Signature over Printed Name of the Teacher-Applicant