Republic of the Philippines

Department of Education
Caraga Administrative Region
Division of Surigao Del Norte
Claver District

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, MA. JUNISSA N. CAGASAN, Filipino of legal age, permanent address at P-2 Brgy.
Panatao, Claver, Surigao del Norte after being sworn in accordance with Law, hereby depose and state
that:

1. I am applying for Teacher I at .

2. I have submitted the following documents:

2.1 Application letter

2.2 CSC Form 212 (Revised 2017) with the latest 2x2 ID picture

2.3 Certified photocopy of Transcript of Records

2.4 Certified photocopy of Board Passer

2.5 Certified photocopy of Good Standing

2.6 Certified photocopy of ratings obtained in each subject area during Licensure Examination for
Teachers (LET)

2.7 Certificates of Specialized Seminars and Training

2.8 Certified photocopy of NBI Clearance

2.9 Omnibus

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

4. I understand that any violation will automatically disqualify me from the selection process.

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

authorized the Department of Education, Division of Surigao City, through the school principal, to verify
the authenticity of the abovementioned documents.

MA. JUNISSA N. CAGASAN

SIGNATURE OVER PRINTED NAME

________________________________
Date

SUSCRIBED AND SWORN TO Before me this _____ day of ____, 2018, affiant exhibiting to me
his/her Community Tax Certificate No._____________ issued on
_______________________________ at ___________________________, Philippines.