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Omnibus Certification of Authenticity and Veracity of Documents

Michelle G. Lemi is applying for a position as a Senior High School Teacher or Junior High School Teacher. She has submitted numerous documents to support her application, including her CSC Form 212, PRC identification card, teacher licensure examination results, transcripts, training certificates, proof of residency, and NBI clearance. She assumes full responsibility for the validity and authenticity of the documents and authorizes the Division of Pangasinan II to verify the documents.

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629 views2 pages

Omnibus Certification of Authenticity and Veracity of Documents

Michelle G. Lemi is applying for a position as a Senior High School Teacher or Junior High School Teacher. She has submitted numerous documents to support her application, including her CSC Form 212, PRC identification card, teacher licensure examination results, transcripts, training certificates, proof of residency, and NBI clearance. She assumes full responsibility for the validity and authenticity of the documents and authorizes the Division of Pangasinan II to verify the documents.

Uploaded by

tabilin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Form 2

Region 1
DIVISION OF PANGASINAN II
Binalonan,Pangasinan

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY


OF DOCUMENTS

I, Michelle G. Lemi, Filipino, of legal age, with permanent address at


Inamotan, Manaoag, Pangasinan after being sworn in accordance with law,
hereby depose and state that:

1. I am applying for Senior High School Teacher


2. I have submitted the following documents:

I assume full responsibility and accountability on the validity and authenticity of


all the following documents submitted and I understand that any violation will
automatically disqualify me from the selection process:

 Letter of Intention
 CSC Form 212 (Revised 2005) in two copies with the latest passport
size picture
 Certified photocopy of PRC professional identification card
 Certified photocopy of ratings obtained in the Licensure Examination
for Teachers/Professional Board Examination for Teachers
 Certificate Teaching Experience
 Certified copy of Transcript of Records
 General Weighted Average
 Certificates of specialized trainings, if any
 Certified copy of Voter’s ID and/ or any proof of residency as
deemed acceptable by the School Screening Committee
 NBI Clearance
 Omnibus Certification of authenticity and veracity of all documents
submitted and signed by the applicant

MICHELLE G. LEMI
Printed Name and Signature of Applicant

SUBSCRIBED AND SWORN to before me in City / Municipality of


day of , affiant exhibiting to me his/her
Community tax NO. Issued on at ,
Philippines.
Form 2

Region 1
DIVISION OF PANGASINAN II
Binalonan,Pangasinan

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY


OF DOCUMENTS

I, Michelle G. Lemi, Filipino, of legal age, with permanent address at


Inamotan, Manaoag, Pangasinan after being sworn in accordance with law,
hereby depose and state that:

1. I am applying for Junior High School Teacher


2. I have submitted the following documents:
2.1 CSC Form 212 (revised 2005) in two copies with latest 2x2
ID picture
2.2 Certified photocopy of PRC professional identification card
2.3 Certified photocopy of ratings obtained in the Licensure
Examination for Teachers/ Professional Board Examination
for Teachers
2.4 Certified copy of transcript of records
2.5 Copies of service record/ certificate of employment,
performance rating, and school clearance for those with
teaching experience.
2.6 Photocopies of certificates of specialized training, if any
2.7 Certified copy of Voter’s ID and/or any proof of residency as
deemed acceptable by the School Screening Committee
2.8 NBI Clearance

3. I am executing this certification to attend to the authenticity and


veracity of all documents submitted.

4. By executing the Omnibus Certification of Authenticity and


Veracity of Documents. I hereby authorize the Department of
Education, Division of Pangasinan II through the School Principal, to
verify the authenticity of the abovementioned documents.

MICHELLE G. LEMI
Signature over printed name

Date

SUBSCRIBED AND SWORN to before me in City / Municipality of


day of , affiant exhibiting to me his/her
Community tax NO. Issued on at
, Philippines.

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