Republic of the Philippines

DEPARTMENT OF EDUCATION
Region XII
SCHOOLS DIVISION OF SOUTH COTABATO
City of Koronadal

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, JEAN ROSE G. GENTIZON, Filipino, of legal age, with permanent address at Purok Rosas, Dajay,
Surallah, South Cotabato, after being sworn in accordance with the aw, hereby despose and state that:

1. I am applying for Junior High School at Surallah National High School;

2. I have submitted the following documents:

2.1.1 Application Letter

2.1.2 Personal Data Sheet (CSC Form 212 revised 2017)
2.1.3 Certified photocopy of Eligibility
2.1.4 Certified photocopy of Credentials
2.1.5 Certified Photocopy of Specialized Training
2.1.6 Certified Photocopy of Service Record
2.1.7 Proof of Residency
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 authorized the Department of Education, Division of South Cotabato through the
School Principal, to verify the authenticity of the above-mentioned documents.

JEAN ROSE G. GENTIZON

Signature over printed name

_________________________________
Date

SUBSCRIBED AND SWORN TO before me this _________________ day of _______________________, 2023, affiant
Exhibiting to me his/her Community Tax Certificate No. _________________________ issued on __________________
at _______________________________________, Philippines.

________________________________
Public Attorney II