Republic of the Philippines

Region V
Department of Education
Division of Camarines Sur
Caramoan District

OMNIBUS SWORN CERTIFICATION

Republic of the Philippines )

Division of Camarines Sur )
Tabgon National High School)
Caramoan, Camarines Sur

AFFIDAVIT

I, NELVINCENT CHRISTIAN A. NACIDO, of legal age, single, Filipino and residing in Tabgon, Caramoan,
Camarines Sur, after having been duly sworn in accordance with the Law, do hereby depose and state that:

1. I am the owner of the following documents submitted to the School Screening Committee:
a) Handwritten Application Letter
b) CSC Form 212 Revised Personal Data Sheet
c) Latest Barangay Certification
d) Certified photocopy of PRC Professional Identification Card
e) Certified photocopy of Eligibility Rating
f) PSA Birth Certificate
g) Certified copies of Transcript of Records
h) Certification of General Weighted Average (GWA)
i) Copies of Service Records, or Certificate of Employment
j) Certificate of Specialized Trainings
k) Certified copy of Voter’s Certification
l) NBI Clearance
m) Omnibus certification of authenticity and veracity of all documents submitted, signed by the
applicant.

2. Each document submitted is in satisfaction and compliance with the requirements for recruitment set by
the Department of Education;
3. Each document is an authentic copy of the original, complete, and all data/information therein are
true and correct to the best of my knowledge and belief;
4. I assume responsibility and accountability on the validity and authenticity of the documents
submitted; and
5. I am authorizing the School Screening Committee to verify/validate the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of February, 2020 in Caramoan,
Philippines.

NELVINCENT CHRISTIAN A. NACIDO

Signature of Applicant

SUBSCRIBED AND SWORN TO before me this __ day of February, 2020, affiant exhibiting to me
his/her Community Tax Certificate No. ______________ issued on ____________ in Caramoan, Philippines.

Doc No. ___________

Page No. __________
Book No. __________
Series of___________