Republic of the Philippines

Province of Ilocos Sur

Municipality of Burgos
BARANGAY DIRDIRIG

Office of the Punong Barangay

BARANGAY CLEARANCE

TO WHOM IT MAY CONCERN:

This is to CERTIFY that MRS. MARIETA Q. DATO, legal of age, and a resident of
Barangay Dirdirig, Burgos, Ilocos Sur. She is well known to me to have a good moral character
and law abiding citizen.

This is to CERTIFY FURTHER that she never been convicted nor identified with any
crimes as shown in the records of the barangay.

This is CERTIFY FURTHER that she is a breadwinner of their family and the persons
stated below are living together as one household:

Name Relation
Jhon-Mar Q. Dato Son
JM Dato Son

This CERTIFICATION is issued upon the personal request of MARIETA Q. DATO for
general purposes.

Issued this 17th day of July, 2020 at Dirdirig, Burgos, Ilocos Sur.

MARIETA Q. DATO RONNEL A. CASTRO

Subject Punong Barangay

CTC No.: __________

Issued on __________
Issued at Burgos, Ilocos Sur