Republic of the Philippines

Province of Leyte
Municipality of Inopacan
BARANGAY TAO-TAON
-oOo-

OFFICE OF THE PUNONG BARANGAY

BARANGAY CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that GRACE RIÑA TIMON, 48 years old and MICHAEL PAGUIPO BIBAT
locally reside at Brgy. Tao-taon Inopacan, Leyte were live-in partners (common law) for 10 years from 2013 up to
present at Purok 5, Brgy. Tao-taon Inopacan, Leyte.

This CERTIFICATION is being issued upon the request of the interested party for whatever legal purposed
it may serve.

Done this 24TH day of AUGUST, 2023 at Brgy. Tao-taon, Inopacan, Leyte.

Approved:

HON. MARGARITA Q. LEMITA

Punong Barangay

Paid under O.R. No. : ___________________

Issued on : ___________________
Issued at : ___________________

NOT VALID
WITHOUT SEAL