Republic of the Philippines

Province of Camarines Sur

Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for MEDICAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
NOT VALID WITHOUT DRY SEAL
Control No._____ Series of 2022

Republic of the Philippines

Province of Camarines Sur
Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for MEDICAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
Control No._____ Series of 2022 NOT VALID WITHOUT DRY SEAL
 Republic of the Philippines
Province of Camarines Sur
Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for EDUCATIONAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
NOT VALID WITHOUT DRY SEAL
Control No._____ Series of 2022

Republic of the Philippines

Province of Camarines Sur
Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for EDUCATIONAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Republic of the Philippines
Issued at: _______________________ Province of Camarines Sur
Issued on: ______________________ Municipality of Pili
Control No._____ Series of 2022 Barangay CADLAN NOT VALID WITHOUT DRY SEAL

OFFICE OF THE PUNONG BARANGAY

 ================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for FINANCIAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
NOT VALID WITHOUT DRY SEAL
Control No._____ Series of 2022

Republic of the Philippines

Province of Camarines Sur
Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for FINANCIAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Republic of the Philippines
Issued at: _______________________ Province of Camarines Sur
Issued on: ______________________ Municipality of Pili
Control No._____ Series of 2022 Barangay CADLAN NOT VALID WITHOUT DRY SEAL

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
 This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for BURIAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
NOT VALID WITHOUT DRY SEAL
Control No._____ Series of 2022

Republic of the Philippines

Province of Camarines Sur
Municipality of Pili
Barangay CADLAN

OFFICE OF THE PUNONG BARANGAY

================================================================
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that ________________________________________, of legal age, Filipino citizen,
a resident of ________, Cadlan, Pili, Camarines Sur, _____________ of ___________________________
belongs to indigent family and has no derogatory record in this Barangay.

This certification is being issued upon request of the above-named person for BURIAL
ASSISTANCE of his/her _____________, _______________________________.

Given this _____ day of ________________2022 at Cadlan, Pili, Camarines Sur, Philippines.

____________________________
(Signature of Applicant) WALDEN DOMINGO P. BRUSAS
Punong Barangay
Comm. Tax Cert. No. ____________ THUMBMARK
Issued at: _______________________
Issued on: ______________________
Control No._____ Series of 2022 NOT VALID WITHOUT DRY SEAL