(Enclosure to Division Memorandum No. 002, s.

2015)

QUEZON ST,, MASBATE CITY

Address

OMNIBUS CERTIFICATION

TO WHOM IT MAY CONCERN:

I hereby certify as to the AUTHENTICITY and VERACITY of the copies of following

documents;

1. CSC Form 212 (revised 2005) in two copies with the latest 2”x2” ID picture
2. Certified photocopy of PRC professional identification card
3. Certified photocopy of ratings obtained in the Licensure Examination for
Teachers/Professional Board Examination for Teachers
4. Certified copies of transcript of records
5. Copies of service record, performance rating and school clearance for those with teaching
experience
6. Certificates of specialized training, if any
7. Certified copy of the Voters ID and/or any proof of residency as deemed acceptable by the
School Screening Committee
8. NBI Clearance
9. Omnibus certification of authenticity and veracity of all documents submitted, signed by the
applicants.

I further certify that all the statement and information provided therein are true and correct.

MARY GLENY ROSE A. 3 ASIA

Applicant

Subscribed and Sworn to before me this ________day of ___________________, 2022, affiant

exhibiting to me his/her Community Tax Certificate no. _________________ issued on ____________ at
___________________________________, Philippines.

____________________________
NOTARY PUBLIC

Doc No. ____________

Page No. ___________
Book No. ___________
Series of __________