REPUBLIC OF THE PHILIPPINES

PROVINCE OF MISAMIS OCCIDENTAL

OFFICE OF THE PUNONG BARANGAY

C E R T I F I C A T I O N

TO WHOM IT MAY CONCERN:

This is to certify that ______________, of legal age, single, is a student of

_________________ (located at, Jimenez, Misamis Occidental.

This certifies further that the above-mentioned name has no travel history
abroad, not a person under monitoring (PUM), not a person under investigation (PUI) of
COVID 19 and did not go to places where there are cases of COVID 19.

This certification is issued upon the request of the interested party in connection
with his desire to apply/avail/acquire permit to pass from Jimenez, Misamis Occidental
to Mahayag, Zamboanga del Sur.

Issued this 24th day of February, 2021 at, Jimenez, Misamis Occidental.

_______________________
Punong Barangay