Omnibus Certification of Authenticity and Veracity of Documents

I, NIÑA HAMILI G. PIAO, Filipino, of legal age, with permanent address at Brgy. Combado,
Maasin City, Southern Leyte, after being sworn in accordance with law, hereby depose and state
that:

1. I am applying for a NURSE POSITION at the Department of Education, Southern

Leyte Division.

2. I have submitted the following documents:

2.1 Application Letter
2.2 Personal Data Sheet
2.3 Service Record or Certificate of Employment
2.4 Performance Ratings
2.5 Relevant Trainings or Awards or Recognition received
2.6 Transcript of Records

3. I am executing this Certification to attest to the authenticity and veracity of all

documents submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity of Documents,

I hereby authorize the Department of Education, Southern Leyte Division Personnel Selection Board
or Division Selection Committee through the Schools Division Superintendent, to verify the
authenticity of the abovementioned documents.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 18 th day of September,

2017 at Maasin City, Southern Leyte, Philippines.

NIÑA HAMILI G. PIAO

SUBSCRIBED AND SWORN TO before me this 18th day of September, 2017 at Maasin City,
Southern Leyte, Philippines.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2017