Republic of the Philippines

Province of Pangasinan
Municipality of San Jacinto
BARANGAY SAN JOSE

OFFICE OF THE PUNONG BARANGAY

CERTIFICATE OF INDIGENCY

TO WHOM IT MAY CONCERN:

This is to certify that Mr./Mrs.

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Single /married, of legal age, and a resident of Barangay San Jose, San Jacinto, Pangasinan is among

those person whose family is considered as indigent in our Barangay.

This certification is issued upon the request of Mr./Mrs.

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For whatever purpose it may serve him/her.

Issued this __________ day of _____________________2023 at Barangay San Jose

San Jacinto, Pangasinan.

Hon. Rollie S. Banda

Punong Barangay