Republic of the Philippines

DEPARTMENT OF EDUCATION
Region 12
SCHOOLS DIVISION OFFICE OF NORTH COTABATO

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY

OF DOCUMENTS
I, Kristiane B. Bermejo, Filipino, of legal age, with permanent address at
Poblacion 1, Banisilan, North Coatabato after being sworn in accordance with law, hereby depose and
state that:

1. I am applying for a senior high position at Banisilan National High School,

School

__Baranggay Poblacion 1_, ___Banisilan_, ___North Cotabato__.

Address of School Municipalit Province

that I understood well the DepEd Order 14, s. 2014 (Hiring Guidelines for T1
position)

2. I have submitted the following documents:

a) CSC Form 212 (Revised 2005) in two copies with the latest 2x2 ID picture
b) Certified photocopy of PRC Professional Identification card
c) Certified photocopy of ratings obtained in the Licensure Examination for Teachers /
Professional Board Examination for Teachers
d) Certified copy of transcript of records
e) Copies of service record, performance rating, and school clearance for those with
teaching experience
f) Certificates of specialized training, if any
g) Certified copy of the Voters ID and/or any proof of residency as deemed acceptable
by the School Screening Committee
h) 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, North Cotabato through the Divisions Superintendent ,
to verify the authenticity of the above mentioned documents.

KRISTIANE B. BERMEJO
Signature over printed name

____________________
Date

SUBSCRIBED AND SWORN TO before me this _12th_ day of _January_, 2017, affiant exhibiting to
me his/her Community Tax Certificate No. _24698814__ issued on __January 03, 2017_ at
_Banisilan, North Cotabato_, Philippines.

___________________
Notary Public