Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Laguna

Omnibus Certification of Authenticity and Veracity of Documents

I, ___SHERELYN LLENO PACURIB__, Filipino, of legal age, with permanent address at __272 J.
TINAWIN STREET, BARANGAY 9 IBABA DEL NORTE PAETE, LAGUNA__, after being sworn in
accordance with law, hereby depose and state that:

1. I am applying for ______Teacher I at _____Paete District ,

Position School

_Adao corner Roces Streets, Bagumbayan Paete, Laguna ;

School Address

2. I have submitted the following documents:

a. Letter of Intent
b. CSC Form 212 (Revised 2017) in two copies with the latest ID picture
c. Certified photocopy PRC Professional Identification Card
d. Certified photocopy of ratings obtained in the Licensure Examination for Teachers
(LET)/Professional Board Examination for Teachers (PBET)
e. Certified copy of Transcript of Records
f. Copies of service records, performance rating, and school clearance for those with teaching
experience.
g. Certificates of specialized training, if any
h. Certified copy of the Voter’s ID and/or any proof of residency as deemed acceptable by the
School Screening Committee
i. NBI Clearance
j. Omnibus certification of authenticity and veracity of all documents submitted, signed by the
applicant

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, Division of Laguna through the School Principal, to verify the
authenticity of the abovementioned documents.

___________________________
Signature over printed name

____________________
Date