Omnibus

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OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, MIKEE CABUGNASON PIÑERO, Filipino, of legal age, with permanent address at


675 ROXAS STREET, 1, BAIS CITY, NEGROS ORIENTAL, after being sworn in
accordance with law, hereby depose and state that:

1. I am applying for TEACHER III at DEPED DIVISION OF BAIS CITY who is willing to
be assigned in any schools within the division.
2. I have submitted the following documents:

 Letter of Intent addressed to the Schools Division Superintendent


 CSC Form 212, Revised 2017 (Personal Data Sheet) with the latest passport size ID
picture.
 Photocopy of one (1) government-issued ID
 Certified photocopy of certificate of trainings/ seminars/ participations
 Certified photocopy of employment certificate/s
 National Bureau of Investigation (NBI) Clearance
 Certified photocopy of Transcript of Records
 Certified photocopy of Authenticated PRC License/ Certification/ Career Service
Eligibility
 Certified photocopy of Performance Ratings for the last three (3) rating periods.
 Certificate of outstanding employee awards, innovations, research & development
conducted, publication/ authorship, and certificate of consultancy/ speakership in
trainings/ seminars/ workshops/ symposia, if any
 Omnibus Certification of Authenticity and Veracity of Documents

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 Bais City, Negros Oriental
through the Schools division Superintendent; verify the authenticity of the above-mentioned
documents.

MIKEE CABUGNASON PIÑERO


Signature over printed name

Date: APRIL 18, 2022

SUBSCRIBED AND SWORN to before me in the City/ Municipality of Bais this 18th day of
April 2022, affiant exhibiting to me his/ her Community Tax Certificate No. 03000172 issued at
Bais City on January 28, 2022, at Bais City, Philippines.

__________________________
Notary Public
TABLE OF CONTENTS

 Letter of Intent addressed to the Schools Division Superintendent

 CSC Form 212, Revised 2017 (Personal Data Sheet) with the latest passport size ID

picture.

 Photocopy of one (1) government-issued ID

 Certified photocopy of certificate of trainings/ seminars/ participations

 Certified photocopy of employment certificate/s

 National Bureau of Investigation (NBI) Clearance

 Certified photocopy of Transcript of Records

 Certified photocopy of Authenticated PRC License/ Certification/ Career Service

Eligibility

 Certified photocopy of Performance Ratings for the last three (3) rating periods.

 Certificate of outstanding employee awards, innovations, research & development

conducted, publication/ authorship, and certificate of consultancy/ speakership in

trainings/ seminars/ workshops/ symposia, if any

 Omnibus Certification of Authenticity and Veracity of Documents

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