Republic of the Philippines

Department of Education
Region III
School Division of Zambales

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF

DOCUMENTS

I, _____________________________, Filipino, of legal age, with permanent address at

_________________________________, after being sworn in accordance with law, hereby
depose and state that:

1. I am applying for ______________________at __________________________,

Position Name of School
______________________________;
Address of School

2. I have submitted the following documents:

2.1 CSC Form 212 (revised 2017) in two copies with the latest 2x2 ID picture
2.2 Certified photocopy of PRC professional identification card
2.3 Certified photocopy of ratings obtained in the Professional Board Examination for
Teachers
2.4 Certified copy of transcript of records
2.5 Copies of service record / certificate of employment
2.6 Certificates of specialized trainings
2.7 Certified copy of Voter’s ID and /or any proof of residency
2.8 NBI Clearance

3. I am executing this Certification to attest to the authenticity and veracity of all documents
submitted.
4. I understand that any violation will automatically disqualify me from the selection process.
5. By executing this Omnibus Certification of Authenticity and Veracity of Documents, I
hereby authorize the Department of Education, Division of Zambales through the School Head,
to verify the authenticity of the above mentioned documents.

_______________________
Signature over printed name

______________________
Date

SUBSCRIBE AND SWORN to before me in City / Municipality ___________this _____ day of

____________, 2020, affiant exhibiting to me his/her Community Tax Certificate No.
_________________issued on ____________ at __________________, Philippines.

_______________________
Notary Public