Republic of the Philippines

Province of ______________
Municipality of ___________
BARANGAY ____________
OFFICE OF THE PUNONG BARANGAY

BARANGAY RESIDENCY
__________________________
Punong Barangay

TO WHOM IT MAY CONCERN:

__________________________
Committee on Appropriation
This is to certify that_______________________, of legal age,
__________________________
________, Filipino Citizen, whose specimen signature appears
Committee on Environment below, is a PERMANENT RESIDENT of the Barangay Palabotan,
__________________________ Dupax del Sur, Nueva Vizcaya.
Committee on Agriculture

__________________________
Committee on Peace and Order
__________________________
Committee on Education
Base on records of this office, he/she has been residing at
Barangay Palabotan, Dupax del Sur, Nueva Vizcaya since
_________.

__________________________
This certification is being issued upon the request of the above-
Committee on Infrastructure named person for whatever legal purposes it may serve him/her
best.
__________________________
Committee on Health

__________________________
Issued this day of __________ at Barangay
SK Chairperson Palabotan, Dupax del Sur, Nueva Vizcaya.
__________________________
IPMR

__________________________
Barangay Secretary
____________________
__________________________ Punong Barangay
Barangay Treasurer

__________________________

Barangay Admin Aide

---------------------------------------

Amount Paid :
NOT VALID
Issued at : __________
______________________________
WITHOUT SEAL O.R. No. :
barangay.palabotan@gmail.com

Barangay Palabotan