.CS Form No.

4
Revised 2018

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Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OF SOUTH COTABATO

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. _______________________________

has assumed the duties and responsibilities as __________________ of
_____________________________ effective ____________________.

This certification is issued in connection with the issuance of the

appointment of Ms./Mr. ________________________ as _______________.

Done this ______ day of _________________ in _________.

__________________________
Head of Office/Department/Unit

Date: ________________

Attested by:

_ARLENE L. ALBUNA__
Administrative Officer IV - Personnel

201 file
Admin
COA
CSC For submission to CSC FO
within 30 days from the
date of assumption of the
appointee