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Professional Regulation Commission Action Sheet For Authentication

This document is an action sheet for the authentication of professional documents for Lady Lane Completado Cuberos, a registered professional teacher. The appointment for document claiming is set for August 11, 2021, and a fee of PHP 150.00 has been processed for the authentication of two copies of the Professional Identification Card. The document outlines the requirements for claiming the authenticated documents and the necessary identification needed for the process.

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LADY LANE CUBEROS
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29 views1 page

Professional Regulation Commission Action Sheet For Authentication

This document is an action sheet for the authentication of professional documents for Lady Lane Completado Cuberos, a registered professional teacher. The appointment for document claiming is set for August 11, 2021, and a fee of PHP 150.00 has been processed for the authentication of two copies of the Professional Identification Card. The document outlines the requirements for claiming the authenticated documents and the necessary identification needed for the process.

Uploaded by

LADY LANE CUBEROS
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
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REFERENCE NO: CEWCU7DZJJ6Y | OR: 122110964301 | Amount: PHP 150.

00
Aug 11, 2021 (09:00 AM TO 10:00 AM) - PRC Davao
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: Aug 09, 2021 Please underline: MALE/FEMALE


_______
NAME: CUBEROS, LADY LANE COMPLETADO
_____________________________________________________________________________________________
Last Name First Name Middle Name Married Name
PROFESSION: PROFESSIONAL TEACHER REGISTRATION NO.: 1095698 REGISTRATION DATE: 07/25/2011
(For Professional Teacher, please tick [ ] Elementary [ ] Secondary)

VALIDITY DATE OF PROFESSIONAL IDENTIFICATION CARD (PIC): 07/28/2024 TEL./CP NO.: 09498174052 / 09498174052

PLEASE CHECK BOX FOR TYPE OF DOCUMENT TO BE AUTHENTICATED:


CERTIFICATE OF REGISTRATION (COR) NO. OF COPIES PURPOSE:
CERTIFICATION OF BOARD RATING NO. OF COPIES LOCAL
CERTIFICATION OF GOOD STANDING NO. OF COPIES ABROAD
CERTIFICATION OF PASSING NO. OF COPIES LEGAL
X PROFESSIONAL IDENTIFICATION CARD NO. OF COPIES 2 STATEBOARD
REPORT OF RATINGS NO. OF COPIES OTHERS
OTHERS NO. OF COPIES

FOR PRC PROCESSING


150.00
Amount: ____________________________ Processed by: Prepared by:
_

122110964301
O. R. No.: ___________________________
08/09/2021 ___________________________________ ____________________________________
Date: ___________________________
Signature over printed name Signature over printed name
PAYMAYA-WALLET
Issued by: ___________________________
- Date: ______________________________ Date: ________________________________
Date due: __________________________

NOTE: AUTHENTICATION REQUIRES A VALID PROFESSIONAL IDENTIFICATION CARD.

AUTHENTICATION CLAIM SLIP

PLEASE FILL OUT THIS CLAIM SLIP


NAME: CUBEROS, LADY LANE COMPLETADO
_____________________________________ PROFESSION: PROFESSIONAL TEACHER
___________________________
1095698
REGISTRATION NO.: _____________________________________ 07/25/2011
REGISTRATION DATE: ___________________________
DATE FILED: Aug 09, 2021
_____________________________________ -
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

PLEASE SEE THE REQUIREMENTS AND PROCEDURES AT THE BACK OF THIS SHEET

PRD-07
Rev. 00
October 16, 2020
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