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Annex-C - Checklist-of-Requirements-for TI Applicant

The document is a checklist of requirements for the application of Jesica D. Espelita for the position of Teacher I in the Alaminos City Division. It outlines the necessary documents to be submitted, including certifications, personal data sheets, academic records, and clearances. Additionally, it includes an Omnibus Sworn Statement certifying the authenticity of the information provided and consent for data processing by the Department of Education.

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Jesica Espelita
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61 views1 page

Annex-C - Checklist-of-Requirements-for TI Applicant

The document is a checklist of requirements for the application of Jesica D. Espelita for the position of Teacher I in the Alaminos City Division. It outlines the necessary documents to be submitted, including certifications, personal data sheets, academic records, and clearances. Additionally, it includes an Omnibus Sworn Statement certifying the authenticity of the information provided and consent for data processing by the Department of Education.

Uploaded by

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

CHECKLIST OF REQUIREMENTS

Name of Applicant: Jesica D. Espelita Application Code: __________________________


Position Applied For: Teacher I (to be filled by the HRMO)
Office: Alaminos City Division
Contact Number: 0948-8278363
Religion: Christianity
Ethnicity: None
Person with Disability: Yes ( ) No ( / )
Solo Parent: Yes ( ) No ( / )

Verification
Status of (To be filled-out by the HRMO/HR Office/sub-committee)
Submission
Basic Documentary Requirement (To be filled-out by the Status of
applicant; Remarks
Check if submitted)
Submission
(Check if complied)

Checklist of Requirements and Omnibus Sworn Statement on the


a. Certification on the Authenticity and Veracity (CAV) of the
documents submitted and Data Privacy Consent Form
Letter of intent addressed to the Head of Office, or to the highest
b.
human resource officer
Duly accomplished Personal Data Sheet (PDS)
c. (CS Form No. 212, Revised 2017) and Work Experience Sheet, if
applicable

d. Photocopy of valid and updated PRC License/ID, if applicable

e. Photocopy of Certificate of Eligibility/Report of Rating, if applicable

Photocopy of scholastic/academic record such as but not limited to


f. Transcript of Records (TOR) and Diploma, including completion of
graduate and post-graduate units/degrees, if available

g. Photocopy of Certificate/s of Training, if applicable

Photocopy of Certificate of Employment, Contract of Service, or


h.
duly signed Service Record, whichever is/are applicable

i. Photocopy of latest appointment, if applicable

Photocopy of the Performance Ratings in the last rating period(s)


j. covering one (1) year performance prior to the deadline of
submission, if applicable

k Certified photocopy of Voter's ID and/or any proof of residensy

l National Bureau of Investigation (NBI) clearance

m Other documents as may be required for comparative assessment

Attested:

HRMPSB School Sub-committee Chairperson

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY


I hereby certify that all information above are 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 of the Department and for purposes of compliance with the laws,
rules, and regulations being implemented by the Civil Service Commission.

JESICA D. ESPELITA
Name and Signature of Applicant

Subscribed and sworn to before me this ______ day of __________________ , year _________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (e)lectronic documents shall have the legal effect, validity or enforceability as any other
document or legal writing and a) (w)here the law requires a document to be in writing, that requirement 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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