Professional Regulation Commission

ONE THOUSAND CASE HOURS

WARNING: All statements are subject to verification and any false statement of misrepresentation made in this CERTIFICATE OF EXPERIENCE is a ground for disqualification
and criminal prosecution for falsification.
TO THE BOARD FOR: ____________________________
I HEREBY CERTIFY THAT Mr./Mrs. ________________________________________ has worked with (Name of Office/Firm) _____________________________________
Located at ____________________________________________________________ as follows:

Specific Nature of Name of Supervisor Registration No. &

From To No. of Hours AGENCY
Task/Responsibilities (Reg. ) Date

This is to certify further that M_________________________________________ has actually performed the duties enumerated above under my
direct supervision. I, being a registered ______________________________ with Reg. No. _____________________ dated __________________ that my annual
registration (I.D.) is still enforce and will expire on __________________________________.

Manila, ________________________, 20____.

___________________________________________
(Signature above printed Name of Certifying Officer)

CDO-APP-09
Rev. 00
February 25, 2015
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