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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
2.2
2.3
2.4
2.5
2.6
2.7
2.8

CSC Form 212 (revised 2005)in two copies with the latest
2x2 ID picture
Certified photocopy of PRC professional identification card
Certified photocopy of ratings obtained in the Licensure
Examination for Teachers/ Professional Board Examination
for Teachers
Certified copy of transcript of records
Copies of service record /certificate of employment,
performance rating, and school clearance for those with
teaching experience
Certificates of specialized training, if any
Certified copy of Voters ID and /or any proof of residency
as deemed acceptable by the School Screening Committee
NBI Clearance

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

____________________
Date