Republic of the Philippines

Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OFFICE OF CEBU
TABOGON

OMNIBUS CERTIFICATE OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, JAYSON J. MANGUBAT, FILIPINO of legal age, with permanent address at Ilihan,

Tabogon, Cebu, after being sworn in accordance with law, hereby depose and state that:
1. I am applying for a Teacher 3 position at Ilihan Integrated School, Ilihan, Tabogon, Cebu.
2. I have submitted the following documents:
A. Duly Accomplished ERF-6 copies
B. At least 3 years or more teaching experience with CAR or MA graduate or
C. 20 years or more teaching experience with 20 or more units in MA
D. TOR with Certification, Authentication & Verification (CAV) indicate CAR/Graduate
from CHED if private/ SCHOOL if public-original copy
E. TOR undergrad certified true copy
F. CS form 212 (Personal Data Sheet) – 3 original copies
G. Latest Plantilla (PSIPOP)
H. Latest Approved Appointment-3 Certified True Copies
I. Updated Service Record-1 original & 2 certified true copies
J. Latest Payslip or Payroll -1 certified true copy
K. Performance Rating for the Last 3 School Years (Certified Photocopy signed by
Admin. Officer/District Supervisor/School Head)- 3 copies/sem
L. Certificates of Trainings, Seminars, Workshops Awards (Certified True Copies)
M. Certification signed by the applicant, noted by the School Head & PSDS that the
applicant is not applying for any promotion (natural vacancy/new item except for reclass
N. Sworn Statement that all documents submitted are true and correct with documentary
stamp- 1 original copy
3. I certify that these documents are authentic, true, free from any falsehood and
modification from the original, and that they are earned in good faith by myself.
4. I authorized the Personnel Selection Board/Division Selection Committee to make
inquiry or investigate if needed to determine whether these documents are authentic or true as
certified.
5. I also understand that if any of the submitted documents will be found to be falsified or
fallacious, such will cause my outright disqualification from the evaluation and, consequently,
for the position.

Applicant’s Name

Subscribed and sworn to me before this ______day of _______, affiant exhibiting to me his/her
PRC Number 0930460 issued on December 14, 2006, at _____________________, Philippines.