Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OF LUCENA CITY

Omnibus Certification of Authenticity and Veracity of Documents

I, RONALIE S. FLAVIER, Filipino, of legal age, with permanent address at Purok Masagana, Ibabang Iyam,
Lucena City, after having been duly sworn in accordance with law, hereby depose and state that:

1. I am applying for Teacher 1 at, Lucena West I Elementary School at M.L. Tagarao, Ilayang Iyam, Lucena
City.

2. I have submitted the following documents:

a. Letter of intent addressed to the Schools Division Superintendent
b. CSC Form 212 (revised 2017) Personal Data Sheet in two copies with the latest
Passport size ID picture with signature over printed;
c. Omnibus Certification of authenticity and veracity of all documents submitted
and signed by the applicant
d. Photocopy of Transcript of Records (TOR), (Computation of General Weight
Average (GWA), photocopy of Diploma
e. Photocopy of PRC professional identification card or a PRC certification
showing the teacher’s name, LET rating and other information recorded in the
PRC office, photocopy of ratings obtained in the Licensure Examination for
Teachers
f. Certificates of specialized training program
g. Voter’s certificate issued by the COMELEC
h. NBI Clearance

3. I am executing this Omnibus Sworn Certification to attest to the authenticity and veracity of all documents I
submitted;

4. By executing this Omnibus Certification of Authenticity and Veracity of Documents, I hereby authorize the
Department of Education, Division of Lucena City, to verify the authenticity of the above mentioned documents.

RONALIE S. FLAVIER
Signature over printed name of Teacher Applicant

SUBSCRIBED AND SWORN to before me this 3rd day May of 2023, affiant exhibiting to me his/her PRC ID
No. 1926662 valid until 11-21-2025 at Lucena City, Philippines.

WITNESS MY HAND AND SEAL,

Doc. No.___________________
Page No.___________________
Book No.___________________
Series of. ___________________