Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE ________
SCHOOL
Address

C E R T I F I C A T I O N

This is to certify that ______________________, Teacher III of -

_________________________ School, has no identified learner/s with disabilities, giftedness
and/or talents in her class.

This certification is being issued upon the request of the above-named teacher for
whatever purpose it may serve her.

_______________________
School Head