CS Form No.

4
Revised 2018

Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OF SOUTH COTABATO

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Mrs. JANICE J. DILLO has assumed the duties and
responsibilities as TEACHER - III effective _________________.

This certification is issued in connection with the issuance of the appointment of

Mrs. JANICE J. DILLO as TEACHER - III.

Done this ____ day of __________, 2021 in Department of Education – Schools

Division of South Cotabato, Philippines.

RUTH L. ESTACIO PhD, CESO VI

Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent

Date: ________________

Attested by:

MELVINA D. SORIANO
Administrative Officer II
OIC to the Office of AOIV (Personnel)

For submission to CSC FO

201 file
within 30 days from the
Admin date of assumption of the
COA appointee
CSC