Annex C

CHECKLIST OF REQUIREMENTS

Name of Applicant: CHERELYN A. CATALAN Application Code: _____________________________

Position Applied For: TEACHER I
Office: COGON INTEGRATED SCHOOL
Contact Number: 09197719235
Religion: BAPTIST
Ethnicity: CAPIZNON
Person with Disability: Yes ( ) No ( X )
Solo Parent: Yes ( ) No ( X )

Verification
Status of (To be filled-out by the HRMO/HR Office/sub-committee)
Submission
Basic Documentary Requirement (To be filled-out by the Status of
applicant; Remarks
Check if submitted)
Submission
(Check if complied)

a. Letter of intent addressed to the Head of Office, or to the

b. highest
Duly human resource
accomplished officer
Personal Data Sheet (PDS)
c. Photocopy of valid and updated PRC License/ID, if applicable
d. Photocopy of Certificate of Eligibility/Report of Rating, if
e. applicable
Photocopy of scholastic/academic record such as but not
f. limited to Transcript
Photocopy of Records
of Certificate/s (TOR) and
of Training, Diploma, including
if applicable
g. completionof
Photocopy ofCertificate
graduate and post-graduate
of Employment, units/degrees,
Contract if or
of Service,
h. available
duly signedofService
Photocopy Record, whichever
latest appointment, is/are applicable
if applicable
i. Photocopy of the Performance Ratings in the last rating
j. period(s) covering
Checklist one (1) year
of Requirements andperformance
Omnibus Sworn priorStatement
to the on
k. assessment,
the
Other if applicable
Certification
documents onasthe
mayAuthenticity
be requiredand Veracity (CAV) of the
for comparative
documents
assessment:
Means submitted(MOVs)
of Verification and Data Privacy
showing Consent Form
Outstanding
Accomplishments,
Photocopy Application
of Performance of Education,
Rating obtained from andthe Application
relevant of
Learning
work and Development
experience, reckoned
if performance ratingfrom the date
in Item (i) is of
notlast
issuance
Attested:
relevant toofthe
appointment
position to be filled

Human Resource Management Officer

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY

I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents
submitted herewith are original and/or certified true copies thereof.

DATA PRIVACY CONSENT

I hereby grant the Department of Education the right to collect and process my personal information as stated above, for
purposes relevant to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance
with the laws, rules, and regulations being implemented by the Civil Service Commission.

CHERELYN A. CATALAN
Name and Signature of Applicant

Subscribed and sworn to before me this ______ day of ________________, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (e)lectronic documents shall have the legal effect, validity or enforceability as any other
document or legal writing and a) (w)here the law requires a document to be in writing, that requirement is met by an electronic document if the said electronic document
maintains its integrity and reliability and can be authenticated so as to be usable for subsequent reference.