OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, Hazel Joyce O. Borongan, Filipino, of legal age, with permanent address at

Gabayan, Lazi, Siquijor after being sworn in accordance with law, hereby depose and
state that:

1. I am applying for SHS Teacher II at Campalanas National High School,

Campalanas, Lazi, Siquijor ;

2. I have submitted the following documents:

2.1 Written application letter;

2.2 CSC Form 212 (Revised 2017);
2.3 Authenticated copy of PRC license;
2.4 Certified Photocopy of rating obtained in Licensure Examination for
Teachers;
2.5 Certified Photocopy of Transcript of Records and GWA;
2.6 Certified Photocopy of Service Record;
2.7 Justification letter regarding unavailability of performance and school
clearance;
2.8 Certified Photocopy of Certificates of Specialized Training;
2.9 Certified Photocopy of Voter’s Certification;
2.10 NBI Clearance (optional)

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

documents submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity of

Documents, I hereby authorize the Department of Education, Division of
Siquijor through the School Principal, to verify the authenticity of the
abovementioned documents.

_______________________________
Signature over printed name

SUBSCRIBED AND SWORN TO before me this ____ day of ________________, 2022,

affiant exhibiting his/her competent proof of identity as follows: Identification Card No.
____________ issued by ________________________.
 OMNIBUS CERTIFICATION AND VERACITY OF DOCUMENTS SUBMITTED

I, Hazel Joyce O. Borongan, of legal age, single, Filipino, and residing at

Gabayan, Lazi, Siquijor, after having been duly sworn in accordance with law, do
hereby depose and state that:

1. Each of the documents submitted in satisfaction of the requirements for Hiring

Teacher I position Based on the Reform Actions in Basic Education Sector Reform
Agenda (BESRA) is an authentic copy of the original, complete, and all statements and
information provided therein are true and correct;

2. I am authorizing the School Selection Committee or its duly authorized

representative(s) to verify all the documents submitted;

3. I am aware of and have undertaken the following responsibilities as a Teacher-

Applicant:

a) Carefully examine all of the requirements for Hiring Teacher I position based on
the Reform Actions in Basic Education Sector Reform Agenda (BESRA);

b) Acknowledge all conditions in the Revised Guidelines on Hiring Teacher I position

based on the Reform Actions in Basic Education Sector Reform Agenda (BESRA) –
DepED Order No. 12, s. 2012;

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

_____________ at .

_____________________________________
Signature Over Printed Name

SUBSCRIBED AND SWORN TO before me this ____ day of ________________, 2022,

affiant exhibiting his/her competent proof of identity as follows: Identification Card No.
____________ issued by ________________________.