REFERENCE NO: CEM58GSRCA28 | OR: E2022-10-02781717 | Amount: PHP 75.
00
Oct 04, 2022 (08:00 AM TO 09:00 AM) - PRC Rosales
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: Oct 01, 2022 Please underline: MALE/FEMALE
_______
NAME: CAYABAN, AIKA ABALOS
_____________________________________________________________________________________________
Last Name First Name Middle Name Married Name
PROFESSION: PROFESSIONAL TEACHER REGISTRATION NO.: 1499603 REGISTRATION DATE: 12/12/2016
(For Professional Teacher, please tick [ ] Elementary [ ] Secondary)
VALIDITY DATE OF PROFESSIONAL IDENTIFICATION CARD (PIC): 06/27/2025 TEL./CP NO.: 09508256103
PLEASE CHECK BOX FOR TYPE OF DOCUMENT TO BE AUTHENTICATED:
X CERTIFICATE OF REGISTRATION (COR) NO. OF COPIES 1 PURPOSE:
CERTIFICATION OF BOARD RATING NO. OF COPIES 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
75.00
Amount: ____________________________ Processed by: Prepared by:
_
E2022-10-02781717
O. R. No.: ___________________________
10/01/2022 ___________________________________ ____________________________________
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: CAYABAN, AIKA ABALOS
_____________________________________ PROFESSION: PROFESSIONAL TEACHER
___________________________
1499603
REGISTRATION NO.: _____________________________________ 12/12/2016
REGISTRATION DATE: ___________________________
DATE FILED: Oct 01, 2022
_____________________________________ -
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 MAKE SURE THAT YOU HAVE THE ORIGINAL COPY OF
THE DOCUMENT/S TO BE AUTHENTICATED)
PRD-07
Rev. 00
October 16, 2020
Page 1 of 2