Republic of the Philippines

Municipality of Palompon
Province of Leyte
OFFICE OF THE PUNONG BARANGAY
BARANGAY SAN ISIDRO
brgysanisidro2019@gmail.com
Tel. No. (053) 552-06937

IAN JAY L.
AREVALO CERTIFICATION
Punong Barangay

Sangguniang
Barangay members:
TO WHOM IT MAY CONCERN:
Antonio V. Son
(Sitio Pasil) THIS IS TO CERTIFY that LUCKSONNEY SARI-SARI STORE,
Gilbert R. Pintoy owned by SHERLOCK VICENTE CODILLA, is located in Barangay San
(Sitio Bakilid/Taypo) Isidro, Palompon, Leyte.
Adolfo A. Alvarez III
(Proper/Cacao) This proves that LUCKSONNEY SARI-SARI STORE closed its
business last February 15, 2022, because his wife got sick due to COVID-19.
Arturo B. Vivero
(Brgy. Road/Torril)
THIS CERTIFICATION IS ISSUED upon the request of the interested
Concepcion V. party for BIR Requirement.
Montero
(Sitio San Martin)
ISSUED this 01st day of March 2024 at Palompon, Leyte, Philippines.
Milie A. Villardo
(Sitio Bita-ug)

Victor M. Mercado
(Sitio Salvacion) Prepared by:

Leonel C. Campos
(SK Chairperson)
MARJORIE A. ENCARNACION
Barangay Secretary
Marjorie A.
Encarnacion
Barangay Secretary

Jenny Jean B. Attested by:

Sampan
Barangay Treasurer

Punong Barangay/
Sangguniang Barangay Member

NOT VALID
WITHOUT
OFFICIAL SEAL

“I shall pass through this world but once; Any good thing therefore that I can do; or any kindness that I can show to
anyone; let me do it now; let me not defer nor neglect it; for I shall not pass this way again.”