CS Form No.

4
Revised 2018

Republic of the Philippines

COMMISSION ON AUDIT
Commonwealth Avenue, Quezon City

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:

________________________
HRMO

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