Republic of the Philippines )

Province of _____________)
City of _________________) sc
x-------------------------------------x

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, ______________________________, Filipino, of legal age, married, and a bona

fide resident of __________________, Isabela after having been duly sworn to in
accordance with law, depose that:

1. I am applying for the position of __________________.

2. I have submitted the following documents:

(a) Personal Data Sheet
(b) Transcript of Records
(c) PRC license ID
(d) LET Rating
(e) Performance Rating
(f) Diploma
(g) Certificate of Live Birth
(h) Voter’s Certificate
(i) NBI Clearance
(j) School Clearance (School Record)
(k) Four (4) Certificates of Specialized Training
(l) Certificate of Employment

3. I am executing this Certification to attest to the authenticity and

veracity of all documents submitted. By executing this Omnibus Certification of
Authenticity and Veracity of Documents, I hereby authorize the proper
department or agency, to verify the authenticity of the above-mentioned
documents.

IN WITNESS WHEREOF, I set my hand this ____day of _____, 2022 in

___________, Isabela.

___________________
Affiant
ID No. ___________

SUBSCRIBED AND SWORN TO BEFORE ME on the same date and at the same
place above-written.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2022