Republic of the Philippines

DEPARTMENT OF EDUCATION
Region XI
Division of Island Garden City of Samal
Samal District

OMNIBUS SWORN CERTIFICATION

I,Jamaicah D. Mahinay, of legal age, Filipino, and residing at Purok-3 Barangay Licup, Samal
District, Island Garden City of Samal, Davao del Norte, after having been duly sworn in
accordance with law, do hereby depose and state that:

1. I am applying for a Teacher at Licup Elementary School;

2. I am executing this Omnibus sworn certification to assure authenticity and veracity of all
documents submitted;
3. I assure full responsibility on the validity and authenticity of the documents submitted
and understands that any violation will automatically disqualify me from the selection
process.

IN WITNESS WHEREOF, I have hereunto set of my hands this _________ day of

_______,2021 at Island Garden City of Samal, Philippines.

JAMAICAH D. MAHINAY
Applicant

SUBSCRIBED AND SWORN TO before me this __________ day of _______,2021.

Affliant exhibiting to me his/her Community Tax No. ____________ issued on
________________ at Island Garden City of Samal, Philippines.

____________________
Notary Public