2023 Barangay Clearance Updated

Republic of the Philippines
Province of Sorsogon
MUNICIPALITY OF BARCELONA
BARANGAY STA LOURDES
OFFICE OF THE PUNONG BARANGAY
BARANGAY CERTIFICATION
This is to certify that MRS. NILDA GABUYO is the lawful wife of

MR.RODELO GABUYO of Barangay Sta. Lourdes, Barcelona, Sorsogon.
This certification is issued to Mrs. Nilda Gabuyo as proof of her authorization

to claim the insurance check at the Department of Agriculture issued to Mr. Rodelo
Gabuyo in behalf of her Husband.
Issued this 24th day of July, 2020.
Attested:
HONORABLE RENANTE ARIOLA

Punong Barangay
TO WHOM IT MAY CONCERN:
This is to certify that MR. GENESIS O. ESCARTIN, 39 year old, is a bonafide

resident of Barangay Sta. Lourdes, Barcelona, Sorsogon.
This further certifies that the above named person is not identified as COVID 19 possible,
suspect, probable, confirmed nor has been traced as closed contact. In this connection the above
named person above wants to ask permission to travel from Barangay Sta. Lourdes to Quezon
City.
This certification is being issued upon request of the interested party for whatever legal
purposes it may serve.
Issued this 8th day of February, 2021 at Barangay Sta. Lourdes, Barcelona, Sorsogon.
Attested:

Punong Barangay
Municipality of Barcelona
BARANGAY POBLACION CENTRAL
Annex A
Registration Form
(ROFW/Locally Stranded Individual)
________________________________________________________________________________________
LAST NAME: FIRST NAME: MIDDLE NAME: SUFFIX:
________________________________________________________________________________________________
GENDER: COMPLETE ADDRESS: CONTACT NO. AGE:
____Male ____Female
________________________________________________________________________________________________
Occupation: Emergency Contact Person ORIGIN LGU: DATE OF TRAVEL TO
and Contact Number: (Region,Prov.,City/ RESIDENCE
Mun. Brgy.)
________________________________________________________________________________________________
DESTINATION VEHICLE: DRIVER’S NAME/ DATE OF
TRAVEL
LGU: ____Private CONTACT NUMBER TO RESIDENCE:
(Region,Prov.,City/Mun./Brgy) ____Government
Medical Clearance issued by the

City/Municipal Health Office:
A Medical Clearance Certificate issued
____YES, Date of Issuance: by the City/Municipal Health Office based on the
following conditions.
_________________________
 That the LSI is neither a contact, Suspect or
probable or confirmed COVID-19 case; and
____NO, REASON:  That the LSI completed 14-day quarantine
based on the quarantine standards set by
_________________________
the DOH; or
 That the LSI confirmed as a COVID-19 case
was tested negative through RT-PCR twice
Note:
* - Mandatory Field
**-If available

BARANGAY CLEARANCE
This is to certify that the person whose name, picture and print appearing below requested for a
clearance and the result are as follow:
Name: ROSALIE ESTIPONA HAZ

Address: STA. LOURDES, BARCELONA, SORSOGON
Date of Birth: MAY 6, 1987
Gender: FEMALE
Civil Status: SINGLE
This certifies further that as per record available on this office she has no derogatory record on file up
this date.
That this clearance is issued upon requested of the above interested party as a requirement for DOLE
TUPAD and for whatever legal purposes it may serve.
Given this 8th day of March, 2023 at Barangay Sta. Lourdes, Barcelona, Sorsogon.
Approved by:
HONORABLE RENANTE E. ARIOLA

Punong Barangay
Conform:
___________________________
Signature over Printed Name
CTC No. __________________
Issued on __________________
Barcelona, Sorsogon
Issued at ___________________

This is to certify that ROMEO DOMEGINA ZARSUELA, 63 year old and a bonafide
Further certifies that Romeo Zarsuela died due to his longtime illness and not from COVID 19
viruses.
This certification is issued upon request of the interested party as proof of the real cause of
death of Mr. Zarsuela and for whatever legal purposes it may serve.
Issued this 20th day of January, 2023.
Attested:

Punong Barangay

CERTIFICATE OF INDIGENCY
This is to certify that EJELENE N. ESCULLAR is a bonafide indigent resident of

Barangay Sta. Lourdes, Barcelona, Sorsogon.
That said person needs assistance for the following reason:
Ο Presently Confined at the Hospital

Ο Needs burial Assistance
Ο Scholarship
Ο Medical Assistance
Others__________________________________
Issued this _____ day of ____________, 2023 at Barangay Sta. Lourdes, Barcelona,
Sorsogon.
Attested:

Punong Barangay
This is to certify that _____________________________________ is a bonafide farmer and
resident of Barangay Sta, Lourdes, Barcelona, Sorsogon.
This further certify that she is the owner/heir/tenant of a parcel of land with an area of ______
sq.m/hectares, owned by ___________________________________ located at Barangay
____________________, Barcelona, Sorsogon, devoted to rice farming/ high value crops
production /coconut farming/ banana/ abaca production and raising __ head/s chicken/ __ heads ducks/
___ heads turkey/ ___ heads swine fattener/ ___ heads carabaos/ __ head/s cow/ __ heads sheeps/ ___
head/s horse.
This certification is issued upon request of the above-mentioned name for reference and record
purposes.
Issued this ___ day of ___________________, 2023 at Barangay Sta. Lourdes, Barcelona,
Sorsogon.
Noted by:
HON. RENANTE E. ARIOLA

Punong Barangay
This is to certify that MERLYN HISARZA ALBERTO, of legal age, single and a bonafide
This further certifies that the above named person is not identified as COVID 19 possible,
suspect, probable, confirmed nor has been traced as closed contact.
This certification is being issued upon request of the interested party for whatever legal purposes
it may serve.
Given this 6th day of March, 2023 at Barangay Poblacion Sur, Barcelona, Sorsogon.
Noted by:

Punong Barangay

CERTIFICATE OF RESIDENCY
This is to certify that FIDEL ESPEDILION ESCULLAR SR, (DECEASED), A resident of

Barangay Sta. Lourdes, Barcelona, Sorsogon
This further certifies that the above named person is a resident since 1939 up to the time of his
death.
it may serve.
Noted by:

Punong Barangay

CERTIFICATE OF RESIDENCY
This is to certify that MERLY ESCULLAR of legal age and a resident of Barangay Sta.
Lourdes, Barcelona, Sorsogon
This further certifies that the above named person is the daughter of the deceased Fidel Escullar
Sr.
it may serve.
Noted by:

Punong Barangay

2023 Barangay Clearance Updated

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Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

This is to certify that MRS. NILDA GABUYO is the lawful wife of

This certification is issued to Mrs. Nilda Gabuyo as proof of her authorization

Issued this 24th day of July, 2020.

HONORABLE RENANTE ARIOLA

OFFICE OF THE PUNONG BARANGAY

TO WHOM IT MAY CONCERN:

This is to certify that MR. GENESIS O. ESCARTIN, 39 year old, is a bonafide

HONORABLE RENANTE ARIOLA

OFFICE OF THE PUNONG BARANGAY

Medical Clearance issued by the

Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

Name: ROSALIE ESTIPONA HAZ

HONORABLE RENANTE E. ARIOLA

Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

Issued this 20th day of January, 2023.

HONORABLE RENANTE ARIOLA

Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

This is to certify that EJELENE N. ESCULLAR is a bonafide indigent resident of

That said person needs assistance for the following reason:

Ο Presently Confined at the Hospital

HONORABLE RENANTE ARIOLA

OFFICE OF THE PUNONG BARANGAY

HON. RENANTE E. ARIOLA

OFFICE OF THE PUNONG BARANGAY

HON. RENANTE E. ARIOLA

Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

This is to certify that FIDEL ESPEDILION ESCULLAR SR, (DECEASED), A resident of

HON. RENANTE E. ARIOLA

Republic of the Philippines

HON. RENANTE E. ARIOLA

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