CS Form No.

4
Series of 2018

REPUBLIC OF THE PHILIPPINES

Department of Education
Region IVA (CALABARZON)
CITY SCHOOLS DIVISION OF DASMARINAS
CSDO Building, DASCA Compound, Burol II, Dasmariñas City

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms/Mr. CHARMANE B. DELA OSTIA has

assumed the duties and responsibilities as TEACHER I of STA. CRUZ
ELEMENTARY SCHOOL effective __________________

This certification is issued in connection with the issuance of the

appointment of Ms/Mr Dela Ostia as Teacher I .

Done this ______ day of ________________in ___________________.

ANNA LISSA R. VILLANUEVA

School Principal

Date: _________________________

Attested by:

MARICEL A. MENDOZA
Administrative Officer V

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