CS Form No.

4
Series of 2018

Republic of the Philippines

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CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. ____________________________ has

assumed
(Name of Appointee)

the duties and responsibilities as ______________________________________ of

(Position Title)

_______________________________________ effective ___________________.

(Name of Office/Department/Unit) (Date of Assumption)

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

of Ms./Mr. __________________ as ________________________________.

(Appointee’s Surname) (Position Title)

Done this ____ day of __________ ________ in _________________.

(Location)

___________________________
Head of Office/Department/Unit

Date: ________________
(Date of Assumption)

Attested by:

Division Manager
Human Resources Management

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