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 School
___________________________;
Address of School

2. I have submitted the following documents:
2.1 Transcript of Records
2.2 PRC license ID
2.3 PRC Verification
2.4 NBI Clearance
2.5 CSC form 211 (Medical Certificate)
2.6 NSO Birth Certificate
2.7 Statement of Assets, Liabilities and Networth (SALN)
2.8 BIR Form 1902 or 2305
2.9 Marriage Contract (if applicable)

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



___________________________
Signature over printed name





SUBSCRIBED AND SWORN TO before me this ____ day of ________________, 2014, affiant exhibiting
his/her competent proof of identity as follows: Identification Card No. ____________ issued by
________________________.












OMNIBUS CERTIFICATION AND VERACITY OF DOCUMENTS SUBMITTED

I, _________________, of legal age, single, Filipino, and residing at _____________________________,
after having been duly sworn in accordance with law, do hereby depose and state that:

1. Each of the documents submitted in satisfaction of the requirements for Hiring Teacher I position
Based on the Reform Actions in Basic Education Sector Reform Agenda (BESRA) is an authentic copy of
the original, complete, and all statements and information provided therein are true and correct;

2. I am authorizing the School Selection Committee or its duly authorized representative(s) to verify
all the documents submitted;

3. I am aware of and have undertaken the following responsibilities as a Teacher-Applicant:

a) Carefully examine all of the requirements for Hiring Teacher I position Based on the Reform Actions
in Basic Education Sector Reform Agenda (BESRA);

b) Acknowledge all conditions in the Revised Guidelines on Hiring Teacher I position Based on the
Reform Actions in Basic Education Sector Reform Agenda (BESRA) DepED Order No. 12, s. 2012;


IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of _____________ at Tabuk City,
Kalinga, Philippines.




_____________________________________
Signature Over Printed Name




SUBSCRIBED AND SWORN TO before me this ____ day of ________________, 2014, affiant exhibiting
his/her competent proof of identity as follows: Identification Card No. ____________ issued by
________________________.