OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, HAYDEE ERIKA M. ASUNCION Filipino, of legal age, with permanent address at ZONE 4
SAN ESTEBAN, ALCALA, CAGAYAN, after being sworn in accordance with law, hereby depose and
state that:

1. I am applying for JHS- TEACHER at ALCALA RURAL SCHOOL, AGANI, ALCALA,

CAGAYAN; Position School / Office Address of School /
Office
2. I have submitted the following documents:

a. CSC Form 212 (Revised 2017) in two copies with the latest 2x2 ID picture
b. Certified photocopy of PRC professional identification card or a PRC
certification showing the teacher's name, LET rating, and other
information recorded in the PRC Office
c. Certified photocopy of ratings obtained in the Licensure Examination for
Teachers Board Examination for Teachers (PBET)
d. Certified copy of transcript of records
e. Copies of service records, performance rating, and school clearance for
those with teaching experience.
f. Certificates of specialized training, if any
g. Certified copy of the Voter's ID and/or any proof of residency as deemed
acceptable by the School Screening Committee
h. NBI Clearance

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 _____________, to verify the
authenticity of the abovementioned documents.
HAYDEE ERIKA MERCADO
ASUNCION
Signature over printed name

__________________________
Date

SUBSCRIBED AND SWORN to before me in City / Municipality ________________ this _____ day of
__________, _________, affiant personally appeared and exhibited to me her PRC License bearing No.
1452645 as a competent evidence of identity.

__________________________
Notary Public
Doc. No.
Page No.
Book No. 01
Series of 2022

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS
 I, HAYDEE ERIKA M. ASUNCION Filipino, of legal age, with permanent address at ZONE 4
SAN ESTEBAN, ALCALA, CAGAYAN, after being sworn in accordance with law, hereby depose and
state that:

1. I am applying for SHS- TEACHER at ALCALA RURAL SCHOOL, AGANI, ALCALA,

CAGAYAN; Position School / Office Address of School /
Office
2. I have submitted the following documents:

a. CSC Form 212 (Revised 2017) in two copies with the latest 2x2 ID picture
b. Certified photocopy of PRC professional identification card or a PRC
certification showing the teacher's name, LET rating, and other
information recorded in the PRC Office
c. Certified photocopy of ratings obtained in the Licensure Examination for
Teachers Board Examination for Teachers (PBET)
d. Certified copy of transcript of records and diploma
e. Copies of service records, performance rating, and school clearance for
those with teaching experience.
f. Certificates of specialized training, if any
g. Certified copy of the Voter's ID and/or any proof of residency as deemed
acceptable by the School Screening Committee
h. NBI Clearance

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 Cagayan, to verify the authenticity of
the abovementioned documents.
HAYDEE ERIKA MERCADO
ASUNCION
Signature over printed name

__________________________
Date

SUBSCRIBED AND SWORN to before me in City / Municipality ________________ this _____ day of
__________, _________, affiant personally appeared and exhibited to me her PRC License bearing No.
1452645 as a competent evidence of identity.

__________________________
Notary Public
Doc. No.
Page No.
Book No. 01
Series of 2022