I, Raymond Wagas Gamboa, Filipino, of legal age, with permanent address at

BARANGAY MALABOBO, MANGATAREM, PANGASINAN, after being sworn in

accordance with law, hereby depose and state that:

I am applying for JHS Teacher I at Macarang National High School, Brgy. Macarang,
Mangatarem, Pangasinan

1. I have submitted the following documents:

1.1 CSC Form 212 (Revised 2017) in two copies
with the latest passport ID picture
1.2 Certified photocopy of PRC professional
Identification card
1.3 Certified photocopy of rating obtained in the
Licensure Examination Teacher/Professional
Board Examination for Teachers
1.4 Certified copy of Transcript of Records and Certificate
of General Weighted Average
1.5 Copies of Certificate of Employment and performance rating
1.6 Certificates of specialized seminar and training
1.7 Certificate of voter’s registration
1.8 NBI clearance

2. I am executing this Certification to attest to the authenticity and veracity of

all documents submitted.

3. By executing this Omnibus Certification of Authenticity and Veracity of

Documents, I hereby authorize the Department of Education, SDO
Pangasinan 1 through the School Principal, to verify the authenticity of the
above mentioned documents.

RAYMOND WAGAS GAMBOA

Signature over printed name

02/04/2019
Date

Subscribe and sworn to before me this 4TH day of February, 20 19 at

Alaminos City Pangasinan.