CS Form No.

4
Revised 2018

Republic of the Philippines

Department of Education
Region IVA- CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms/Mr. ______AMMI GRACE L. RAMOS has assumed

(Name of Appointee)

the duties and responsibilities as __ TEACHER II ____ of

(Position Title)

__DEPED – LAGUNA SHS_____________ effective ____________________________.

(Name of Office) (Date of Assumption)

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

of
Ms/Mr. ______RAMOS ______ as _ TEACHER II ___.
(Appointee’s Surname) (Position Title)

Done this ________ day of ______________________ in

____________________________.

________________________________
Head of Office/Department/Unit

Date: ______________________
(Date of Assumption)

Attested by:

LOURDES M. FRESNIDO
Administrative Officer IV

201 file
Admin
COA
CSC

Address: Provincial Capitol Compound, Santa Cruz, Laguna

Telefax: (049) 831-9062 | 566-5013
Email: laguna@deped.gov.ph
Website: www.depedlaguna.com.ph Reg. No. 44 100 18 93 0053
Page 1 of 1
CS Form No. 4
Revised 2018

Republic of the Philippines

Department of Education
Region IVA- CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA

Address: Provincial Capitol Compound, Santa Cruz, Laguna

Telefax: (049) 831-9062 | 566-5013
Email: laguna@deped.gov.ph
Website: www.depedlaguna.com.ph Reg. No. 44 100 18 93 0053
Page 1 of 1