Republic of the Philippines

Province of Pangasinan
MUNICIPALITY OF LAOAC
Barangay INMANDUYAN

OFFICE OF THE PUNONG BARANGAY

CERTIFICATION OF INDIGENCY

_________________
Date

This is to certify that _________________________of legal age, Filipino and

resident of Purok___ is in the list of indigent families of Barangay Inmanduyan
Laoac, Pangasinan.

This certification is issued for whatever legal purposes it may serve.

MELINDA M. LIM
Punong Barangay