REPUBLIC OF THE PHILIPPINES

_______________________________) S.S.
X-------------------------------------------/

OMNIBUS AFFIDAVIT

(RE: AUTHENTICATION OF PERSONAL DOCUMENTS FOR TEACHING STAFF

APPLICANTS)

I, _______________, Filipino citizen, ___ years old, married, and a resident of _____________
Philippines after having been duly sworn to an oath do hereby depose and state:

1. That I am a qualified Teacher applicant for the province of _________, Philippines.

2. In connection thereto, I intend to submit the following documents in support of my
application and in fulfilment of the requirements for the ________ position based on the
reforms actions in Basic Education Sector Reform Agenda (BESRA), to wit.
CSC Form 212 (Revised)
Certified photocopy of Transcript of Records
Certified photocopy of Diploma and Transcript of Records (TOR) on bachelor’s
degree
Certified photocopy of Certificate of Board Rating
Certified photocopy of Certificates & Trainings
Certified photocopy of Certificate of Employment
Certified photocopy of Performance Rating Certificate
Certified photocopy of professional Identification Card

3. That the above-mentioned documents are true and authentic copies from the original thereof
and that all the information provided therein are true and correct; and
4. That I am executing this affidavit as my honest declaration of the foregoing narration of facts
to support my foregoing application before the Office of the Department of Education
(DepED) for ____________ and for whatever legal purpose this may serve me best.

IN WITNESS WHEREOF, I have hereunto set my hands this ____ day of ____ 2023 in
__________, Philippines.

____________________
Affiant

Valid ID & No.:

Issued by: Professional Regulation Commission
Valid Until:

SUBSCRIBED AND SWORN to before me on this ____ day of ______ in ______________ ,

Philippines. Affiant personally appeared and exhibited to me his/her above-cited Competent Evidence of
Identity.