REPUBLIC OF THE PHILIPPINES

PROVINCE OF ZAMBALES
MUNICIPALITY OF BOTOLAN
BARANGAY TAMPO

OFFICE OF THE PUNONG BARANGAY

BARANGAY OFFICIALS
CERTIFICATION FOR CLOSURE OF ESTABLISHMENT

ROBERTO Y. DIVINO JR.

Punong Barangay TO WHOM IT MAY CONCERN:

RUEL E. DOROPAN This is to certify that ANNA LIZA DIÑOSO PATINA the
Barangay Kagawad owner of the business establishment ANNA LIZA SARI SARI STORE
located at the Purok 2, Tampo, Botolan, Zambales were already
ROWENA V. UY been closed by her since December 31, 2020.
Barangay Kagawad
Issued upon request of owner ANNA LIZA D. PATINA for
ROBERTO B. DEVISFRUTO
Barangay Kagawad whatever legal purpose it may serve.

ADOLFO P. VILLANUEVA
Issued this___17th____ day of _____January_____2023.
Barangay Kagawad

EDEN A. ARSOLON
Barangay Kagawad

BENIGNO R. TICMAN JR.

Barangay Kagawad

CORAZON R. PATINA HON. ROBERTO Y. DIVINO JR.

Barangay Kagawad Punong Barangay

SHERWIN D. RAMOS
SK Chairman
O.R. No: 12030801
ROSA VILMA M. DECENA
Barangay Secretary Amount Paid: P 100.00________
Date: JANUARY 17, 2023
REDEN E. DOROPAN
Barangay Treasurer Note: Not valid without official seal.