Republic of the Philippines
)
Province of Camarines Norte
) S.S.
Municipality of __________________)
OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY
I,
_____________
of legal age, single, married, Filipino and residing at
_________________, after having duly sworn in accordance with law, do hereby
depose and state;
1. That I am an
____________-_ applicant at the Department of Education,
Division of Camarines Norte;
2. That each of the documents herein submitted in relation to my application for
non-teaching appointment at DepEd – Camarines Norte Division is an authentic
copy of the original, complete and all statements and information provided
therein are true and correct; to wit:








Personal Data Sheet (CSC Form 212 – Revised 2017 ) in two copies with the
latest 2” x 2” ID picture
Photocopy of Eligibility/Report of Board Rating and PRC Certification of Good
Standing
Photocopy of Transcript of Records with Special Order ( for those who finished the
degree )
Photocopy of Performance Rating for the last 3 rating periods
Photocopy of updated Service Record/Certificate of Employment
Photocopy of Relevant Certificate of Trainings
Photocopy of Documents of Outstanding Accomplishments
Omnibus Certification of Authenticity and Veracity of the documents submitted
3. That I am authorizing the Head of Office/Appointing or it’s duly authorized
representative (s) to verify all the documents submitted.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of
_____________________, 2023 at ____________________________, Philippines.
____________________ _
Affiant
Doc. No.
Page No.
Book No.
Series of:
_______________
_______________
_______________
_______________