REFERENCE NO: CE82Y3NCR4IJ | OR: E2025-02-10984238 | Amount: PHP 75.
00
Feb 20, 2025 (01:00 PM TO 02:00 PM) - Balangkayan, Offsite Service Center
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:             Feb 15, 2025                                             Please underline: MALE/FEMALE
                                                                                                         _______
 NAME:                                   MACOPIA, ROWENA ASIS
                _____________________________________________________________________________________________
                        Last Name              First Name            Middle Name           Married Name
 PROFESSION: PROFESSIONAL TEACHER REGISTRATION NO.:                      2055101         REGISTRATION DATE:          06/09/2023
 (For Professional Teacher, please tick [ ] Elementary [ ] Secondary)
 VALIDITY DATE OF PROFESSIONAL IDENTIFICATION CARD (PIC):                   01/17/2026      TEL./CP NO.:    09105656063
        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       1              STATEBOARD
              REPORT OF RATINGS                                 NO. OF COPIES                      OTHERS
              OTHERS                                            NO. OF COPIES
                                                      FOR PRC PROCESSING
                 75.00
    Amount: ____________________________        Processed by:                            Prepared by:
    _
                 E2025-02-10984238
    O. R. No.: ___________________________
                 02/15/2025                     ___________________________________      ____________________________________
    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:                MACOPIA, ROWENA ASIS
                     _____________________________________               PROFESSION:         PROFESSIONAL TEACHER
                                                                                             ___________________________
                      2055101
 REGISTRATION NO.: _____________________________________                                      06/09/2023
                                                                         REGISTRATION DATE: ___________________________
 DATE FILED:          Feb 15, 2025
                     _____________________________________                            -
                                                                         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
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