TO THE CITY TREASURER , KIDAPAWAN CITY
TO THE CITY TREASURER , KIDAPAWAN CITY
I hereby certify to the correctness of the following infromation.
NAME: ________________________________________
PUROK: _______________________________________
PLACE OF BIRTH:________________________________
DATE OF BIRTH: ________________________________
CIVIL STATUS:_________________ SEX: _____________
CITIZENSHIP: _________________ ACR NO.:__________
HEIGHT: _________________ WEIGHT: _____________
OCCUPATION: _______________ TIN:_______________
4. SALARIES: ________________________
5. GROSS RECEIPTS: __________________
6. INCOME FROM REAL: _______________
PROPERTIES: ____________________________________
CTC NO: _________________ DATE ISSUED: ___________
VERIFIED BY:
____________ SIGNATURE: ________________
TO THE CITY TREASURER , KIDAPAWAN CITY
I hereby certify to the correctness of the following infromation.
NAME: ________________________________________
PUROK: _______________________________________
PLACE OF BIRTH:________________________________
DATE OF BIRTH: ________________________________
CIVIL STATUS:_________________ SEX: _____________
CITIZENSHIP: _________________ ACR NO.:__________
HEIGHT: _________________ WEIGHT: _____________
OCCUPATION: _______________ TIN:_______________
10. SALARIES: ________________________
11. GROSS RECEIPTS: __________________
12. INCOME FROM REAL: _______________
PROPERTIES: ____________________________________
CTC NO: _________________ DATE ISSUED: ___________
VERIFIED BY:
____________ SIGNATURE: ________________
I hereby certify to the correctness of the following infromation.
NAME: ________________________________________
PUROK: _______________________________________
PLACE OF BIRTH:________________________________
DATE OF BIRTH: ________________________________
CIVIL STATUS:_________________ SEX: _____________
CITIZENSHIP: _________________ ACR NO.:__________
HEIGHT: _________________ WEIGHT: _____________
OCCUPATION: _______________ TIN:_______________
1. SALARIES: ________________________
2. GROSS RECEIPTS: __________________
3. INCOME FROM REAL: _______________
PROPERTIES: ____________________________________
CTC NO: _________________ DATE ISSUED: ___________
VERIFIED BY:
____________ SIGNATURE: ________________
TO THE CITY TREASURER , KIDAPAWAN CITY
I hereby certify to the correctness of the following infromation.
NAME: ________________________________________
PUROK: _______________________________________
PLACE OF BIRTH:________________________________
DATE OF BIRTH: ________________________________
CIVIL STATUS:_________________ SEX: _____________
CITIZENSHIP: _________________ ACR NO.:__________
HEIGHT: _________________ WEIGHT: _____________
OCCUPATION: _______________ TIN:_______________
7. SALARIES: ________________________
8. GROSS RECEIPTS: __________________
9. INCOME FROM REAL: _______________
PROPERTIES: ____________________________________
CTC NO: _________________ DATE ISSUED: ___________
VERIFIED BY:
____________ SIGNATURE: ________________