CS Form No. 4 Certificate of Assumption To Duty

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CSC Form No.

4
Revised 2018

Republic of the Philippines


Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO CITY

CERTIFICATE OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. ALEX A. DIAMAAT JR. has assumed the duties and

responsibilities as TEACHER 1(SHS) of AMPON NATIONAL HIGH SCHOOL

effective ____________________.

This certification is issued in connection with the issuance of the appointment of

Ms./Mr. ALEX A. DIAMAAT JR. as TEACHER 1(SHS).

Done this _____ day of _______________ in _________________.

CAROLYN D. DOMINGO
Head of Office/Department/Unit

Date: ________________

Attested by:

GERARD S. PIL
Administrative Officer V__
HRMO

201 File For submission to CSC FO


Personnel Office
within 30 days from the
COA
CSC date of assumption of the
appointee

Address: Elpidio Quirino Avenue, Davao City


Telephone No: (082) 224-3274, (082) 222-1672
E-mail: davao.city@deped.gov.ph

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