PERTINENT DOCUMENTS OF

APPLICATION FOR
TEACHER-I
(Secondary)

VIBERLIE B. BALABA
Applicant
 TABLE OF CONTENTS

CSC form (Revised 2017) with 2x2 picture …………………………………………………… A

Certified Photocopy of PRC Certicate/ PRC ID ……………………………………………… B

Certified Photocopy of LET Ratings ………………………………………………………….. C

Certified Copies of Transcript of Records

With General Weighted Average ……………………………………………………………….. D

Copies of Service of Records …………………………………………………………………… E

Certificate of Specialized Training …………………………………………………………….. F

Certified copy of Voter’s Certification/

Proof of Residency ……………………………………………………………………………….. G

Omnibus Certification ……………………………………………………………………………. H

I hereby certify that the papers attached are true and correct.

VIBERLIE B. BALABA
Teacher I Applicant
 CSC form 212
(revised 2017)

Figure 1
Certified Photocopy of
PRC certificate/PRC ID
Certified Photocopy of
LET Ratings
 Certified Copies of
Transcript of Records
with Weighted Average
Copies of Service of
Records
Certificate of Specialized
Training
Certified Copy of Voter’s
Certification
 Omnibus Certification

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, Viberlie Bagares Balaba,Filipino, 24 of legal age, with permananent address at Casinglot,

Tagoloan, Misamis Oriental,after being sworn in accordance with law,hereby depose and
state that:

1. I am applying for Teacher-I at Casinglot National High School, Casinglot, Tagoloan,

Misamis Oriental.
2. I have submitted the following documents:
A. CSC Form 212 (revised 2017) with the latest 2x2 ID picture
B. Certified photocopy of PRC professional identification card
 C. Certified photocopy of ratings obtained in the Professional Board
Examination for Teachers
D. Certified copy of Transcript of Records (TOR)
E. Certified copy of General Weighted Average (GWA) signed by the university
Registrar
F. Certified copy of Service Record,Performance Ratings and School clearance
for those with teaching experience
G. Certified copy of Voter’s ID/Certificate
H. Omnibus Certification of Authenticity and Veracity of all documents
3. That I assume full responsibility and accountability on the validity and authenticity
of all documents submitted, and I understand that any violation will automatically
disqualify me from the selecting process.

I hereby authorize the Department of Education, Division of Misamis Oriental, to verify

the authenticity of the above-mentioned documents.

VIBERLIE B.BALABA
Signature over Printed Name

____________________________
Date

SUBSCIRBED AND SWORN to before me in City/Municipality ______________________ this

______of_____________,2023,affiant exhibiting to me his/her Community Tax Certificate
No.________issued on _________________ at
__________________________________________,Phillipines.

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, Viberlie Bagares Balaba,Filipino, 24 of legal age, with permananent address at Casinglot,

Tagoloan, Misamis Oriental,after being sworn in accordance with law,hereby depose and
state that:

4. I am applying for Teacher-I at Tagoloan Senior High School, Tagoloan, Misamis

Oriental.
5. I have submitted the following documents:
I. CSC Form 212 (revised 2017) with the latest 2x2 ID picture
J. Certified photocopy of PRC professional identification card
 K. Certified photocopy of ratings obtained in the Professional Board
Examination for Teachers
L. Certified copy of Transcript of Records (TOR)
M. Certified copy of General Weighted Average (GWA) signed by the university
Registrar
N. Certified copy of Service Record,Performance Ratings and School clearance
for those with teaching experience
O. Certified copy of Voter’s ID/Certificate
P. Omnibus Certification of Authenticity and Veracity of all documents
6. That I assume full responsibility and accountability on the validity and authenticity
of all documents submitted, and I understand that any violation will automatically
disqualify me from the selecting process.

I hereby authorize the Department of Education, Division of Misamis Oriental, to verify

the authenticity of the above-mentioned documents.

VIBERLIE B.BALABA
Signature over Printed Name

____________________________
Date

SUBSCIRBED AND SWORN to before me in City/Municipality ______________________ this

______of_____________,2023,affiant exhibiting to me his/her Community Tax Certificate
No.________issued on _________________ at
__________________________________________,Phillipines.