CS Form No.

4
Revised 2018

Republic of the Philippines

DIVISION OF LEYTE
Government Center, Candahug, Palo Leyte

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. Patrick Jerome B. Silvano has assumed

the duties and responsibilities as Teacher-I of DEPED-MacArthur National
Highschool effective _________________.

This certification is issued in connection with the issuance of the

appointment of Ms./Mr. Patrick Jerome B. Silvano as Teacher-I.

Done this ____ day of __________ ________ in ______________.

________________________
Head of Office/Department/Unit

Date: ________________

Attested by:

JOSE MARIANO E. BARRIL, JR.,PhD, JD

Administrative Officer IV/HRMO II

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