REPUBLIC OF THE PHILIPPINES
PROVINCE OF
MUNICIPALITY OF
BARANGAY
OFFICE OF THE PUNONG BARANGAY
CERTIFICATION
General Purpose
Cert. No.:
Date:
O.R. No.:
Full Name
Age
Civil Status
Nationality
Purok / Street
TO WHOM IT MAY CONCERN:
This is to certify that the above-named person is a bonafide resident of this barangay and is personally known to this office.
This certification is issued upon the request of the above-named person for the purpose of:
and for whatever legal purpose it may serve.
Issued this
day of
, at Barangay
, Municipality of
.
For Official Use Only
Requested by (Signature or Thumb Mark)
Signature / Pangalan ng Aplikante
Right
Thumb
Mark
Kanan
Left
Thumb
Mark
Kaliwa
Para sa hindi
makakalagda
Date Requested
Released by (Secretary)
Punong Barangay
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