Republic of the Philippines

Department of Education
REGION X – NORTHERN MINDANAO
REGION X – NORTHERN MINDANAO
| DIVISION OF MISAMIS ORIENTAL |
Velez–Del Pilar Sts., Cagayan de Oro City 9000 (088)8564524 09178992245 misamis.oriental@deped.gov.ph www.depedmisor.net

CS Form No. 4
Revised 2018

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms/Mr. ___________________________________ has assumed

the duties and responsibilities as ________________________________ of
__________________________________ effective ___________________________.

This certification is issued in connection with the issuance of the appointment of Ms/Mr
________________________________________ as ________________________.

Done this _______ day of __________ ________ in ______________.

__________________________
Head of Office/Department/Unit

Date: ___________________

Attested by:

MELANIE C. ESTENZO
AO IV-HRMO II

201 file
For submission to CSC FO
Admin within 30 days from the
COA date of assumption of the
CSC
appointee

Sa K to 12, level-up ang pangarap; sa Misamis Oriental, imong kaugmaon mahayag!