CS Form No.

4
Revised 2018

Republic of the Philippines

Department of Education
ORMOC CITY DIVISION
Ormoc City

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. LENGIE S. DALUPAN has assumed

the duties and responsibilities as SECONDARY SCHOOL PRINCIPAL III of
______________________________ effective _______________________.

This certification is issued in connection with the issuance of the appointment

of Ms./Mr. LENGIE S. DALUPAN as SECONDARY SCHOOL PRINCIPAL III.

Done this _____ day of in Ormoc City, Leyte.

__________________________
Head of Office/Department/Unit

Date: ___________________

Attested by:

MAHALIA M. LAURON
HRMO

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