Republic of the Philippines

Province of Siquijor
Municipality of Siquijor
Barangay Canal

“ATONG LUNGSOD ATONG PANGGA-ON”

“SMOKE FREE MUNICIPALITY”

OFFICE OF THE BARANGAY CAPTAIN

BARANGAY CLEARANCE

To whom me it concern:

This is to certify that REGINE MAGHANOY OCSO, 28 yrs old, single and a residence of
Barangay Canal, Municipality of Siquijor, Province of Siquijor is personally known to me to be a
person of good moraI in this community and never been accused of any crime or misdemeanor.

This certification is issued upon the request of the above-named person to support with
whatever legal purpose it may serve.

Done 12th day of April 2019 at Barangay Canal at Siquijor, Siquijor.

ROBIN B. MARCHAN
Barangay Captain

OR No. : _________
Date Issued: _________
Amount Paid: _________