OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, MARY ANN DASAN BARREDO Filipino, of legal age, with permanent address at PUROK
CAGASAN BGRY. POBLACION, POLOMOLOK SOUTH COTABATO, after being sworn in
accordance with law, hereby depose and state that:

1. I am applying for TEACHER 1 at TUGBONGAN ELEMENTARY SCHOOL,

Position Name of School

LOWER TUGBONGAN, CONSOLACION, CEBU_;

Address of School

2. I have submitted the following documents:

2.1 CSC Form 212 (revised 2005) in two copies with the latest 2x2 ID
picture
2.2 Certified photocopy of PRC professional identification card
2.3 Certified photocopy of ratings obtained in the Professional Board
Examination for Teachers
2.4 Certified copy of transcript of records
2.5 Copies of service record / certificate of employment
2.6 Certificates of specialized trainings
2.7 Certified copy of Voter’s ID and /or any proof of residency
2.8 NBI Clearance
2.9. Omnibus Certification

3. I am executing this Certification to attest to the authenticity and veracity of all documents submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity of Documents, I hereby

nauthenticity of the abovementioned documents.

__________________________
Signature over printed name

__________________________
Date

SUBSCRIBED AND SWORN to before me this _____ day of __________, 2022, affiant exhibiting to me
his/her Community Tax Certificate No. issued on
at , Philippines.

__________________________
Notary Public

Until
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Place
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(Enclosure to Division Memorandum No. , s.2022)
To be accomplished by Teacher Applicant

(REPUBLIC OF THE PHILIPPINES)

)S.S.

SWORN STATEMENT FOR TEACHER 1 APPLICANT

I, NYLIAN A. JOROLAN , Filipino, of legal age, single and with residence and postal address at
IBABAO TUGBONGAN, CONSOLACION, CEBU, Cebu Philippines, after having been sworn to,
depose and say:

1) That, I am an applicant for Teacher 1 position in the schools Division of Cebu Province and was
included in the Registry of Qualified Applciants (RQA) for SY 2021-2022 posted on February 28,
2022 ;
2) That, I however was not favored to be appointed in the school/station, hence wish to apply again in
the Ranking of Teacher 1 applicants for SY 2022-2023;
3) That, in my interest to apply for Teacher 1 position for SY 2022-2023, I intend to retain the points I
earned in the previous RQA and I am aware that my rank in the RQA may be changed because there
might be other applicants who will earn points higher than mine;
4) That, in lieu of my intention to retain points that I garnered in the previous RQA, I will not present
additional documents and thus, stick to the documents previously submitted including rating for the
English Proficiency Test (EPT);
5) I attest to the veracity of the foregoing statements and execute this Affidavit for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand and affix my signature this
at , Philippines.

Affiant
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this

at ,Philippines, affiant is
personally known to this notary public.

Doc No.
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Book No.
Series of 2022