CS Form No.

4
Series of 2017

Republic of the Philippines

Department of Education
Region IX, Zamboanga Penionsula
DIVISION OF ZAMBOANGA DEL SUR
Pagadian City

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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 ________________________.

Done this ____ day of __________ ________ in ______________.

JEANELYN A. ALEMAN
Schools Division Superintendent

Date: ________________

Attested by:

EVA G. CASTRO
Administrative Officer IV

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