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Omnibus

The document is an Omnibus Sworn Statement and Data Privacy Consent Form required for applicants applying for positions within the Department of Education. It includes a checklist of necessary documents for submission and certifies the authenticity and veracity of the information provided by the applicant. Additionally, it grants permission for the Department to process the applicant's personal information in compliance with relevant laws.

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dulnuankrisele14
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85 views2 pages

Omnibus

The document is an Omnibus Sworn Statement and Data Privacy Consent Form required for applicants applying for positions within the Department of Education. It includes a checklist of necessary documents for submission and certifies the authenticity and veracity of the information provided by the applicant. Additionally, it grants permission for the Department to process the applicant's personal information in compliance with relevant laws.

Uploaded by

dulnuankrisele14
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Enclosure No. 1 to Division Memorandum No. 6 s.

2024
Omnibus Sworn Statement on Certification and Veracity (CAV) & Data Privacy Consent Form

Name of Applicant: _______________________________________


Position Applied For: _______________________________________
School: _______________________________________
Contact Number: _______________________________________
Religion: _______________________________________
Ethnicity: _______________________________________
Person with Disability: Yes ( ) No ( )
Solo Parent: Yes ( ) No ( )
Status of Verification
Submission (To be filled out by sub-
(To be filled committee)
Basic Documentary Requirement out by the Status of
applicant;
check if
Submission Remarks
(Check if
submitted)
complied)
a Checklist of Requirements and Omnibus Sworn Statement on the Certification on the
Authenticity and Veracity (CAV) of the documents submitted and Data Privacy
Consent Form
b Letter of intent addressed to the Head of Office
c Duly accomplished Personal Data Sheet (PDS) (CS Form No. 212, Revised 2017)
and Work Experience Sheet
d Photocopy of valid and updated PRC License/ID, if applicable
e Photocopy copy of Certificate of Eligibility/Report of Rating, if applicable
f Photocopy of scholastic/academic record such as but not limited to Transcript of
Records (TOR) and Diploma, including completion of graduate and post-graduate
units/degrees with the certification of the School Registrar of their computed
General Weighted Average (GWA)
g Photocopy of certificate/s of trainings/seminars, if applicable
h Photocopy of Certificate of Employment, Contract of Service, or Duly signed Service
Record by an authorized officer, whichever is/are applicable
i Photocopy of latest appointment, if applicable
j Photocopy of the Performance Ratings in the last rating period(s) covering one (1)
year performance prior to the deadline of submission, if applicable
k Other documents as may be prescribed by the HRMPSB

OMNIBUS SWORN STATEMENT


CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all informations above are true and correct, and of my personal knowledge and
belief, and the documents submitted herewith are original and/or certified true copies thereof.
DATA PRIVACY CONSENT
I hereby grant the Department of Education the right to collect and process my personal information as
stated above, for purposes relevant to the recruitment, selection, and placement of personnel of the
Department and for purposes of compliance with the laws, rules, and regulations being implemented by
the Civil Service Commission.

___________________________
Name and Signature of
Applicant

Subscribed and sworn to before me this ______ day of ______________, year__________.

_______________________________
Person Administering Oath
In consonance with Republic Act No. 8792 or the “Electronic Commerce Act of 2000”, electronic documents shall have the legal
effect, validity or enforceability as any other document or legal writing and where the law requires a document to be in writing,
that requirement is met by an electronic document if the said electronic document maintains its integrity and reliability and can
be authenticated so as to be usable for subsequent reference.

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