OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, ______________________, Filipino, of legal age, with present address at

__________________________________, after being sworn in accordance with law, hereby depose and
state that:

I am applying for TEACHER I at ___________________________________________________

Position School

____________________________________________________________________________________.
Address of School

1. I have submitted the following documents:

1.1 CSC Form 212 (Revised 2005) in two copies with the latest passport ID picture
1.2 Certified photocopy of PRC Certificate of Registration and License
1.3 Certified photocopy of rating obtained in the Licensure Examination for
Teachers/ Professional Board Examination for Teachers
1.4 PRC Certificate of Good Standing
1.5 Transcript of Records and Certificate of General Weighted Average
1.6 Copies of certificate of employment and performance rating
1.7 Certificates of specialized seminar and training
1.8 Certificate of voter’s registration
1.9 NBI Clearance

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

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

hereby authorize the Department of Education, Division of Navotas City through the School Principal, to
verify the authenticity of the abovementioned documents.

______________________
Signature over printed name

June 7, 2017
Date