OMNIBUS

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OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, JUAN, Filipino, of legal age, with permanent address at BACOLOD, after being sworn in accordance
with law, hereby depose and state that:

1. I am applying for TEACHER- 1 at _______________________,


Position Name of School

_____________________________________________ ;
Address of School

2. I have submitted the following documents:

a. Letter of Intent
b. CSC Form 212 (revised 2017) in two copies with the latest 2x2 ID picture
c. Certified Photocopy of PRC Professional Identification Card
d. Certified Photocopy of Ratings Obtained in the Professional Board
Examination for Teachers
e. Certified Copy of Transcript of Records
f. Copies of Service Record / Contract of Service
g Certificate of Specialized Training
h. Certified copy of Voter’s ID and /or any Proof of Residency
i. NBI Clearance
j. Hiring Application Privacy Notice

3. I am executing this Certification to attest to the authenticity and veracity of all documents
submitted.

4. By executing this Omnibus Certification of Authenticity and Veracity of Documents, I hereby


authorize the Department of Education, Division of Bacolod District, to verify the authenticity of the
abovementioned documents.

JUAN
Signature over printed name

SUBSCRIBED AND SWORN to before me this _____ day of __________, 2023, affiant exhibiting
to me his/her competent proof of identity as follows: Identification Card No.__1234567__ issued by
____PRC, Cagayan de Oro____.

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