Republic of the Philippines

Department of Education
Region XII
Schools Division of South Cotabato

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, LUZVIMINDA D. LAMZON, Filipino, married, of legal age with permanent

address at Brgy. Duengas, Surallah, South Cotabato after being sworn in accordance with
the law hereby depose and say that:

1. I am a teacher applicant for the Equivalent Records Form (ERF) and Reclassification
of Teaching Position of the Department of Education.

a) Updated Service Record

b) Certificates of Training and Seminars
c) Copy of Transcript of Records, CAV(Master’s Degree)
d) Performance Rating
e) Duly Accomplished CSC Form 212 (Personal Data Sheet)
f) Latest Appointment
g) Certificate of Recognition for any related school accomplishment
h) Copy of PRC License

2. I am executing this certification to attest to the authenticity and veracity of all

documents submitted.

3. By executing this Omnibus Certification of Authenticity and Veracity Documents, I

hereby authorize the Department of Education to verify the authenticity of the above
—mentioned documents.

IN WITNESS WHERE OF, I have set my hands this 28th day of January, 2022.

LUZVIMINDA D. LAMZON
Name and Signature of Applicant

SUBSCRIBED AND SWORN to before me this _____ day of ________________,

2022, affiant exhibiting his/her residence Certificate No. _________________ at
__________________________________ on _____________________________.