Annex “A”

Barangay KIAS
City/Municipality of BAGUIO CITY
Province of BENGUET
PUNONG BARANGAY’S CERTIFICATION (PBC)

PBC No. : 2019-Kias-

Date: April 1, 2019
To: The Bank Manager
Philippine Veterans Bank
Pine Lake View Building, Rizal Park road 1,
_Corner Otek St., Baguio City

Sir/Madam:

This is to certify that the following checks were duly issued by Barangay _______
(Ito ay pagpapatunay na ang mga cheke na nakalista sa ibaba ay na-isyu ng Barangay Kias

complete with respective Disbursement Vouchers and supporting documents.

na kompleto ng kanya-kanyang Disbursement Vouchers at kalakip na mga dokumento.)

Account No. Check No. Date Payee Amount Purpose

Electrical consumption

Monetization payment
for leave credit of 2018

This Certification is issued, pursuant to COA Circular 2019-1, dated January 30,
2019,
(Itong Patunay ay ginawa alinsunod sa COA Circular 2019-1, na may petsang January 30, 2019

as a condition for the encashment of said checks.

bilang kondisyon para sa pagpapapalit ng mga nasabing cheke.)

The undersigned attests to the truthfulness of the foregoing facts, under pain of
(Pinapatototohanan ng may lagda ang mga nakasaad sa itaas, batid ang …

liability for falsification, pursuant to Article 171(4) of the Revised Penal Code.
pananagutan sa kasong “Falsification,” sang-ayon sa Article 171(4) ng Revised Penal Code.)

SUBSCRIBED AND SWORN to before me, this 10th day of April 2019
By TIMOTHY C. PUDLAO JR. who exhibited to me his Community Tax Certificate
No. 06455807 issued at Baguio City on January 04, 2019.

Very truly yours,

________________________
Punong Barangay
 Annex “A”
Barangay KIAS
City/Municipality of BAGUIO CITY
Province of BENGUET
Delivered by: Received by:

LIEZLE P. MENZI

Barangay Treasurer Bank Representative