_____________________________, 2013

Mr. /Miss/Mrs. __________________________________School Principal

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY

Sir/Madam:

The undersigned applicant is a holder of valid certificate of registration/professional license as teacher from the Professional Regulation Commission (PRC) seeking to be appointed to a Teacher I position for elementary/secondary.

Pursuant to DepEd Order No. 12, s. 2012 dated February 01, 2012 which provides the Revised Guidelines on the Hiring of Teacher I Positions Based on the Reform Actions in Basic Sector Reform Agenda (BESRA) the undersigned applicant respectfully submits her/his written application supported by the following documents:

CSC Form 212 (Revised 2005) in two copies with the latest 2” x 2” ID pictures;

Certified photocopy of PRC Certificate of Registration/License

Certified photocopy of rating obtained in the Licensure Examination for Teachers/Professional Board Examination for Teachers;

Certified copies of transcript of records for baccalaureate course;

Copies of service record, performance rating and school clearance for those with teaching experience;

Copies of Certificate of specialized training;

Certified copy of the Voter’s ID; and

NBI Clearance

The undersigned applicant assume full responsibility and accountability on the validity and authenticity of the foregoing documents submitted and commits that any violation will automatically disqualify the undersigned applicant from the selection process.

Very truly yours,

____________________________________Applicant

SUBSCRIBED AND SWORN to before me this _____________________________ dayof ___________________ 2013 at ________________________by the affiant who showed to me his/her _____________________________ as competent proof of his/her identity.

Doc. No. ___________________;Page No. ___________________;Book No. __________________;Series of ___________________;