CS Form No.

4
Revised 2018

Republic of the Philippines

COMMISSION ON AUDIT
Commonwealth Avenue, Quezon City

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. ______________________________ has

assumed the duties and responsibilities as ________ of ___________
effective _________.

This certification is issued in connection with the issuance of the

appointment of Ms./Mr. ____ as ___________.

Done this _ day of _________ in _________ .

_____________________________
State Auditor IV
OIC-Supervising Auditor

Date: _ _

Attested by:

__ _
Chief Administrative Officer
Service Chief
Administration, Training and Finance Services

201 file
Admin
COA
CSC For submission to CSC FO
within 30 days from the
date of assumption of the
appointee