00 Mar 12, 2024 (11:00 AM TO 12:00 PM) - MIMAROPA (Quezon City) NOTE: This appointment date might be different to the date of claiming of the requested authenticated documents Professional Regulation Commission ACTION SHEET FOR AUTHENTICATION
DATE FILED: Mar 10, 2024 Please underline:_____
MALE/FEMALE NAME: NIEBRES, JANMIG CASTRO _____________________________________________________________________________________________ Last Name First Name Middle Name Married Name PROFESSION: PROFESSIONAL TEACHER REGISTRATION NO.: - REGISTRATION DATE: - (For Professional Teacher, please tick [ ] Elementary [ ] Secondary)
VALIDITY DATE OF PROFESSIONAL IDENTIFICATION CARD (PIC): TEL./CP NO.: 09361274734
PLEASE CHECK BOX FOR TYPE OF DOCUMENT TO BE AUTHENTICATED:
CERTIFICATE OF REGISTRATION (COR) NO. OF COPIES PURPOSE: X CERTIFICATION OF BOARD RATING NO. OF COPIES 1 LOCAL CERTIFICATION OF GOOD STANDING NO. OF COPIES ABROAD CERTIFICATION OF PASSING NO. OF COPIES LEGAL PROFESSIONAL IDENTIFICATION CARD NO. OF COPIES STATEBOARD REPORT OF RATINGS NO. OF COPIES OTHERS OTHERS NO. OF COPIES
E2024-03-07834426 O. R. No.: ___________________________ 03/10/2024 ___________________________________ ____________________________________ Date: ___________________________ Signature over printed name Signature over printed name PAYMAYA-GCASH Issued by: ___________________________ - Date: ______________________________ Date: ________________________________ Date due: __________________________
NOTE: AUTHENTICATION REQUIRES A VALID PROFESSIONAL IDENTIFICATION CARD.
AUTHENTICATION CLAIM SLIP
PLEASE FILL OUT THIS CLAIM SLIP
NAME: NIEBRES, JANMIG CASTRO _____________________________________ PROFESSION: PROFESSIONAL TEACHER ___________________________ - REGISTRATION NO.: _____________________________________ - REGISTRATION DATE: ___________________________ DATE FILED: Mar 10, 2024 _____________________________________ - DATE DUE: _____________________________________
PLEASE PRESENT THIS SLIP TO CLAIM DOCUMENTS AT ______________ ON ______________________. PRC REGISTERED REPRESENTATIVE SHOULD PRESENT ANY VALID GOVERNMENT-ISSUED ID AND AUTHORIZATION LETTER; IF NOT REGISTERED PROFESSIONAL, PRESENT SPECIAL POWER OF ATTORNEY(SPA)AND ANY VALID GOVERNMENT-ISSUED ID.
REGISTRATION OFFICER
IMPORTANT NOTES:
1. PLEASE ENSURE THAT YOU BRING THE ORIGINAL DOCUMENT YOU
WISH TO HAVE AUTHENTICATED. 2. ADDITIONALLY, PLEASE REMEMBER TO BRING THE CORRESPONDING NUMBER OF PHOTOCOPIES OF THE SAME DOCUMENT THAT REQUIRE AUTHENTICATION.
