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PRC Document Authentication Form

The document is an action sheet for the authentication of documents for Leven Egay Panique, a professional teacher, with an appointment scheduled at the PRC Cebu Main Office on November 20, 2023. The authentication request includes three copies of the certification of board rating for local purposes, with a processing fee of PHP 225. Important notes remind the applicant to bring the original document and the required photocopies for authentication.

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Leven Egay
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3 views1 page

PRC Document Authentication Form

The document is an action sheet for the authentication of documents for Leven Egay Panique, a professional teacher, with an appointment scheduled at the PRC Cebu Main Office on November 20, 2023. The authentication request includes three copies of the certification of board rating for local purposes, with a processing fee of PHP 225. Important notes remind the applicant to bring the original document and the required photocopies for authentication.

Uploaded by

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

REFERENCE NO: CEVML273AH2K | OR: E2023-11-06591166 | Amount: PHP 225.

00
Nov 20, 2023 (02:00 PM TO 03:00 PM) - PRC Cebu - Main Office (Initial Registration, PIC Renewal, Certifications)
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: Nov 17, 2023 Please underline: MALE/FEMALE


_______
NAME: PANIQUE, LEVEN EGAY
_____________________________________________________________________________________________
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.: +639754775624

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 3 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

FOR PRC PROCESSING


225.00
Amount: ____________________________ Processed by: Prepared by:
_

E2023-11-06591166
O. R. No.: ___________________________
11/17/2023 ___________________________________ ____________________________________
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: PANIQUE, LEVEN EGAY
_____________________________________ PROFESSION: PROFESSIONAL TEACHER
___________________________
-
REGISTRATION NO.: _____________________________________ -
REGISTRATION DATE: ___________________________
DATE FILED: Nov 17, 2023
_____________________________________ -
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.

PRD-07
Rev. 00
October 16, 2020
Page 1 of 2

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