Republic of the Philippines

Department of Education
Region VIII
SCHOOLS DIVISION OF TACLOBAN CITY

CHECKLIST OF REQUIREMENTS
(To be accomplished in two (2) copies)

Name of Applicant: ________________________ Position Applied For: ___________________

Course: ________________________ Contact Number: ______________________
Person with Disability: ( ) Yes ( ) No If Yes, please state the nature of disability: _______

Verification
Status of
(To be filled out by the
Submission
School Screening
(To be filled
Committee)
Basic Documentary Requirement out by the
Status of
applicant done
Submission
by checking if Remarks
(Check if
submitted)
complied)
a. Checklist of Requirements (see attached Enclosure 1)
b. Letter of Intent
c. CSC Form 2012 (Revised 2017) in two copies with latest
2x2 ID picture
d. Certified photocopy of PRC Professional Identification
Card
e. Certified photocopy of ratings obtained in the Licensure
Examination for Teachers (LET) or Professional Board
Examination for Teachers (PBET)
f. Certified copy of Transcript of Records (TOR) with
Weighted General Average (GWA) signed by the
School/University Registrar
g. Copies of Service Record, Performance Ratings (3 rating
periods) and school clearance for those with teaching
experience.
h. Certificate/s of specialized training (if any)
i. Certified copy of voter’s ID and/or any proof of residency
as deemed acceptable by the School Screening Committee
j. NBI Clearance
k. Omnibus certification of the completeness, authenticity
and veracity of all documents submitted, signed by the
applicant

Submitted by: Verified by:

________________________________ ________________________________________
Printed Name & Signature of Applicant Printed Name & Signature of Verifying Personnel
 Republic of the Philippines
Department of Education
Region VIII
SCHOOLS DIVISION OF TACLOBAN CITY

OMNIBUS CERTIFICATION OF AUTHENTICITY AND

VERACITY OF DOCUMENTS
I, (your complete name), of (complete address) respectfully submit the herein Folder
containing the documents incidental to my application for _________.

I certify that these documents are authentic, true, free from any falsehood and
modification from the original, and that they are actually earned in good faith by myself.

I authorize the Personnel Selection Board/Division Selection Committee to make inquiry

or investigate if needed to determine whether or not these documents are authentic or
true as certified.

I also understand that in the event that any of the submitted documents will be found to
be falsified or fallacious, such will cause my outright disqualification from the evaluation
and, consequently, for the position.

SIGNATURE OVER PRINTED NAME

DATE

Subscribed and sworn to before me this ____ day of ____, 2021 at ______, Tacloban

NOTARY PUBLIC