Republic of the Philippines )

________________________) S.s.

SWORN CERTIFICATION OF RESIDENCY

(with House Location Sketch)

I, ________________, of legal age, Filipino citizen and a resident of

___________________, Cebu, Philippines after having duly sworn to in accordance with law do
hereby voluntarily depose and say:

1. THAT, I am the Barangay Chairman of Barangay _________________________;

2. THAT, I verify that the present address of the petitioner,
______________________., is at
#_________________________________________;
3. THAT, the petitioner has been residing thereat for at least six (6) months prior to
the date of filing of the petition since he was born and raised in this barangay;
4. THAT, attached herewith is the certified copy of the house location sketch as
ANNEX “A”;
5. THAT, I am executing the instant Sworn Certification in order to attest to the
truth of the foregoing and for whatever legal purposes it may serve.

_________________________
Punong Barangay
ID:______________

SUBSCRIBED AND SWORN to before me, in __________________, this

______________ by affiant who exhibited to me his competent evidence of identity indicated
above.

Doc No.:_______;
Page No.: ______;
Book No.:______;
Series of 2022