Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE OF VIGAN CITY

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, JANSEN A. BACOLORES, Filipino, of legal age, with permanent address at GUIMOD NORTE, SAN
JUAN, ILOCOS SUR, after being sworn in accordance with law, hereby depose and state that:

1. I am applying for PROJECT DEVELOPMENT OFFICER I at SCHOOLS DIVISION OFFICE OF

VIGAN CITY that I understood well DepEd Order No. 007, s. 2023.

2. I have submitted the following documents:

2.1 PDS (CS Form 212, Revised 2017) and Work Experience Sheet
2.2 Photocopy of PRC professional identification card
2.3 Photocopy of Certificate of Eligibility
2.4 Photocopy of ratings obtained in the Licensure Examination for
Teachers/ Professional Board Examination for Teachers
2.5 Photocopy of Transcript of Records
2.6 Copies of service record /certificate of employment, performance rating,
and school clearance for those with teaching experience
2.7 Photocopy of Certificates of specialized training
2.8 Photocopy of Certified copy of Voter’s certificate
2.9 NBI Clearance

3. I am executing this Certification to attest to the authenticity and veracity of all documents
submitted.
4. I understand that any violation will automatically disqualify me from the selection process.
5. By executing this Omnibus Certification of Authenticity and Veracity of Documents, I hereby
authorize the Department of Education, SDO Ilocos Sur through the School Head, to verify the
authenticity of the abovementioned documents.

JANSEN A. BACOLORES
Signature over printed name

NOVEMBER 13, 2023

Date

SUBSRIBED AND SWORN TO before me this __________ day of ___________, 2023 affiant exhibiting to
me his/her Community Tax Certificate No. 22071397 issued on Jan. 12, 2023 at Vigan City, Ilocos Sur,
Philippines.

____________________
Notary Public