Omnibus 1
Omnibus 1
Omnibus 1
Department of Education
Region II – Cagayan Valley
Schools Division of Nueva Vizcaya
DIADI DISTRICT
Diadi, Nueva Vizcaya
a) CSC Form 212 (revised 2017) in two copies with the latest passport size 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 photocopy of transcript of records
e) Copies of service records, performance rating, teaching experience
f) Certificates of specialized training
g) Certified copy of Voter’s 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, SDO of Nueva Vizcaya through the School
Head, to verify the authenticity of the above-mentioned documents.
______________________________
Signature over Printed Name
______________________________
Date
SUBCRIBED AND SWORN TO before me this this _____ day of __________, 20__, affiant
exhibiting to me his/her Community Tax Certificate No. ___________ issued on ____________
at _____________________________________________________________, Philippines.
Notary Public