Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-CALABARZON
Division of Rizal

OMNIBUS CERTIFICATION OF AUTHENTICITY

AND VERASITY 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) (School)

_____________________________;
(address)

2. I have submitted the following documents:

a. CSC Form 212 (revised 2017) in two copies with the latest 2x2 ID picture
b. Certified photocopy of PRC professional identification card or a PRC certification
showing the teacher’s name, LET rating and other information recorded in the
PRC Office.
c. Certified photocopy of ratings obtained in the Licensure Examination for
Teachers (LET) / Professional Board Examination for Teachers (PBET)
d. Certified copy of transcript of records.
e. Copies of service record /certificate of employment, performance rating, and
school clearance for those with teaching experience.
f. Certificates of specialized training, if any.
g. Certified copy of Voter’s ID and /or any proof of residency as deemed acceptable
by the School Screening Committee.
h. NBI Clearance
i. Drug Test
j. Psychological Test
k. Neuro-Psychiatric Test

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 Rizal through the School
Principal, to verify the authenticity of the abovementioned documents.

______________________________________
Signature Over Printed Name of Applicant

___________________________________
Date