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J-Checklist-with-Omnibus-Data-Privacy-Consent (1)

checklist with data privacy consent form

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Richelle Edisan
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7 views

J-Checklist-with-Omnibus-Data-Privacy-Consent (1)

checklist with data privacy consent form

Uploaded by

Richelle Edisan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Annex C

CHECKLIST OF REQUIREMENTS

Name of Applicant___________________________________ Application Code


_________________
Position Applied for__________________________________
District/School Applied______________________________
Contact Number_____________________________________
Religion_____________________________________________
Ethnicity____________________________________________
Person with Disability: Yes ( ) No ( )
Solo Parent: Yes ( ) No ( )

Basic Documentary Requirement Status Verification


Submission (To be filled out by the
(To be filled HRMO/HR Office/sub-
out by the committee
applicant,
Check if Status of Remarks
submitted) Submission
(Check if
complied)
a Letter of Intent addressed to the
Schools Division Superintendent
(name of school applied for must be indicated in
the letter)
b Duly accomplished Personal Data
Sheet (PDS) (CS Form 212, Revised
2017 and Work Experience Sheet, if
applicable
c Certified true copy of valid and
updated PRC License/ID, if
applicable
d Certified true copy of
eligibility/board rating, if applicable
e Certified true copy of
scholastic/academic record such as
but not limited to Transcript of
Records (TOR) and Diploma,
including completion of graduate
and post-graduate units/degrees, if
applicable
f Certified true copy of Certificate/s of
Training, if applicable
Certified copy of Certificate of
g Employment, Contract of Service, or
duly signed Service Record,
whichever is/are applicable
h Certified true copy of the latest
appointment, if applicable
i Certified true copy of the
Performance Ratings in the last
rating period(s) covering one (1)
year performance prior to the
assessment, if applicable
j Checklist of Requirements and
Omnibus Sworn Statement on the
Certification on the Authenticity and
Veracity (CAV) of the documents
submitted and Data Privacy Consent
For (Annex C)
k Certified true copy of COMELEC ID or
Voter’s Registration Certification

l Certified true copy of NBI


Clearance and PSA/NSO
m Other documents as may be
required for comparative
assessment such as but not
limited to:
Means of Verification (MOVs)
showing Outstanding
Accomplishments, Application of
Education, and Application of
Learning and Development
reckoned from the date of last
issuance of appointment
Photocopy of Performance Rating
obtained from the relevant work
experienced, if performance
rating in item (i) is not relevant to
the position to be filled
Attested by:

_____________________________________
Human Resource Management Officer

OMNIBUS SWORN STATEMENT


CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above is true and correct, and of my personal
knowledge and belief, and the documents submitted herewith are original and/or
certified true copies thereof.

DATA PRIVACY CONSENT


I hereby grant the Department of Education the right to collect and process my
personal information as stated above, for purposes relevant to the recruitment,
selection, and placement of personnel in the Department of Education and for the
purposes of compliance with the laws, rules, and regulation being implemented by
the Civil Service Commission.

__________________________________
Name and Signature of Applicant

SUBSCRIBED AND SWORN TO before me this _______day of _________________, 2024 at


______________________________________affiant exhibiting her PRC ID card with Registration No.
___________valid until .

Person Administering Oath

In consonance with Republic Act No. 8792 or the “Electronic Commerce Act of 2000”, electronic documents shall
have legal effect, the validity or enforceability as any other documents or legal writing, and where the law requires
a document to be in writing, that requirements is met by an electronic document if the said electronic document
maintains its integrity and reliability and can be authenticated so as to be usable for subsequent reference.

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