CS Form No.

4
Series of 2017

Republic of the Philippines

DIVISION OF MASBATE PROVINCE
Department of Education
Region V
Masbate

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms. ______________________________ has assumed

the duties and responsibilities as TEACHER-I (JHS) of BURGOS NHS, Burgos,
Batuan, Masbate effective _________________________.

This certification is issued in connection with the issuance of the appointment

of Ms. _______________ as Teacher-I (JHS).

Done this ____ of _______________ in DepEd Masbate Province.

BEBIANO T. SENTILLAS
Schools Division Superintendent

Date: _____________________

Attested by:

CHARMAINE L. SAHAGUN
Administrative Officer IV
Personnel

201 file
Admin
COA
CSC
For submission to CSCFO within 30
days from the date of assumption of
the appointee