CS Form No.

4
Series of 2018

Republic of the Philippines

Department of Education
Region V (Bicol)
SCHOOLS DIVISION OFFICE OF ALBAY

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 ________________________.

Legazpi City
Done this ____ day of __________ ________ in ______________.

NORMA B. SAMANTELA, CESO VI

Schools Division Superintendent

Date: ________________

Attested by:

EVELYN R. LIM
Administrative Officer IV/HRMO

For submission to CSCFO

201 file within 30 days from the
Admin
COA date of assumption of the
CSC appointee

Ligñon Hill, Bogtong, Legazpi City

(052)7425380 / (052)7425381
albay@deped.gov.ph
CS Form No. 4
Series of 2018

Republic of the Philippines

Department of Education
Region V (Bicol)
SCHOOLS DIVISION OFFICE OF ALBAY

Ligñon Hill, Bogtong, Legazpi City

(052)7425380 / (052)7425381
albay@deped.gov.ph