Republic of the Philippines

Department of Education
Region V
SCHOOLS DIVISION OF SORSOGON
SORSOGON

OMNIBUS CERTIFICATION
I, ANTHONY SIBAOT NIMO, Filipino, of legal age, with permanent address at PUROK-
MANGINGISDA II, BRGY. STA. CRUZ, DONSOL, SORSOGON, after having been duly sworn in
accordance with law, do hereby depose and state that:

1. I am applying for a Teacher 1 position at DONSOL NATIONAL COMPREHENSIVE HIGH

SCHOOL-STA.CRUZ EXTENSION, STA. CRUZ, DONSOL, SORSOGON that I
understand well the DepEd Order 14, s. 2014 (Hiring Guidelines for Teacher 1 Position); and
2. I am the owner of the following documentary requirements submitted to the School Screening
Committee:
a. Checklist of Requirements
b. Letter of Intent
c. CSC Form 212 (Revised 2017) with the latest 2x2 ID picture
d. Certified photocopy of professional identification card or a PRC certification showing the
teacher’s name, LET rating, and other information recorded in the PRC Office.
e. Certified photocopy of ratings obtained in the Licensure Examination for Teachers (LET)
Professional Board Examination for Teachers (PBET)
f. Certified copy of Transcript of Records
g. Copies of service records, performance rating, and school clearance for those with
teaching experience
h. Certificates of specialized training, if any.
i. Certified copy of proof of residency as deemed acceptable by the School Screening
Committee
j. NBI Clearance/Police Clearance
k. Omnibus certification of authenticity and veracity of all documents submitted, signed by
the applicant.
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.

By executing this OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY

OF DOCUMENTS, I hereby authorize the Department of Education, SDO Sorsogon through
the School Head, to verify the authenticity of the abovementioned documentary requirements.

IN WITNESS WHEREOF, I have hereunto set my hands this day of in ,

Philippines.

ANTHONY SIBAOT NIMO

Signature over printed name of the Applicant

SUBSCRIBED AND SWORN TO before me this day of , 2021, affiant

exhibiting to me his/her Community Tax Certificate No. , issued on in ,
Philippines

Doc. No: _____

Page No: _____
Book No: _____
Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF SORSOGON
SORSOGON

PERTINENT PAPERS FOR

TEACHER- 1 POSITION

(JUNIOR HIGH SCHOOL)

ANTHONY S. NIMO
Applicant

Contact Number:
+63935-728-5575

Email Address:
nimo.toni96@gmail.com
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF SORSOGON

Enclosure No. 01 to Division Memorandum No.165, s. 2021

CHECKLIST OF REQUIREMENTS
Name of Applicant: ANTHONY SIBAOT NIMO
Address: PUROK MANGINGISDA II, BARANGAY STA. CRUZ, DONSOL, SORSOGON
Course: BACHELOR OF SECONDARY EDUCATION MAJOR IN ENGLISH
Contact Number: 0935-728-5575 (TM)
Religion: ROMAN CATHOLIC
Ethnicity:
Person with Disability: YES ( ) NO (/)
Solo Parent: YES ( ) NO(/)

Basic Documentary Requirements

Status of Verification (To be filled-out by
Submission the Receiving School Head)
(To be
filled- out Status of
by the Submission
applicant; Remarks
(Check if
Check if complied)
submitted)
1. Checklist of Requirements /
2. Letter of Intent /
3. CSC Form 212 (Revised 2017) with the latest 2x2 ID /
picture
4. Certified photocopy of PRC professional Identification
card or a PRC certification showing the teacher’s
/
name, LET rating and other information recorded in
the PRC office
5. Certified photocopy of ratings obtained in the Licensure
Examination for Teachers (LET)/Professional Board /
Examination for Teachers (PBET)
6. Certified copy of Transcript of Records /
7. Copies of service records, performance rating, and
school clearance for those with teaching experience. /

Balogo Complex. Brgy. Balogo, Sorsogon City, Sorsogon 4700

Landline: (056)421-5415
Email: sorsogon@deped.gov.ph
Website: depedsorsogon.com.ph
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF SORSOGON

8. Certificates of specialized training, if any /

9. Certified copy of the Voter’s ID and/or any proof of residency as /
deemed acceptable by the School Screening Committee
10. NBI Clearance/Police Clearance /
11. Omnibus certification of authenticity and veracity of all documents /
submitted, signed by the applicant

Verified by: ARLENE B. ONTORIA, HT-1

Signature over printed name of
Receiving School Head

OMNIBUS CERTIFICATION AND WAIVER

This is to certify that all information above is true and correct, and that the documents submitted
are authentic. This is also to authorize the Department of Education, Schools Division of
Sorsogon Province to use my personal information for purposes of recruitment, selection and
hiring.

ANTHONY SIBAOT NIMO

Signature over printed name of the Applicant

Attested:

GIDEON KARL L. GREFALDA

Administrative Officer IV (HRMO)

Balogo Complex. Brgy. Balogo, Sorsogon City, Sorsogon 4700

Landline: (056)421-5415
Email: sorsogon@deped.gov.ph
Website: depedsorsogon.com.ph
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF SORSOGON
SORSOGON

TABLE OF CONTENTS

PAGE
DOCUMENTARY REQUIREMENTS
NUMBER
a) Checklist of Requirements 1-2
b) Omnibus certification of authenticity and veracity of all documents
3
submitted, signed by the applicant.
c) Letter of Intent 4
d) CSC Form 212 (Revised 2017) with the latest 2x2 ID Picture 5-8
e) Certified photocopy of professional identification card or a PRC
certification showing the teacher’s name, LET rating, and other 9-11
information recorded in the PRC Office.
f) Certified photocopy of ratings obtained in the Licensure Examination
for Teachers (LET) Professional Board Examination for Teachers 12
(PBET)
g) Certified copy of Transcript of Records and Certification of General
13-16
Weighted Average
h) Copies of service records, performance rating, and school clearance
17-18
for those with teaching experience
i) Certificates of specialized training, if any. 19-27
j) Certified copy of proof of residency as deemed acceptable by the
28
School Screening Committee
k) NBI Clearance/Police Clearance 29

Balogo Complex. Brgy. Balogo, Sorsogon City, Sorsogon 4700

Landline: (056)421-5415
Email: sorsogon@deped.gov.ph
Website: depedsorsogon.com.ph