Attachment 11

CERTIFICATION

This is to certify that the sample households listed below are no longer residing in the
address provided in the List of Sample Housing Units and Sample Households of the
Philippine Statistics Authority for reasons indicated opposite the household head’s
name based on the information provided by the nearest/adjacent household and/or
coordination with the barangay officials by ______________________, the assigned
Statistical Researcher for the January 2024 Labor Force Survey & Family Income &
Expenditure Survey Visit 2.

Sample Household Name Address Interview Status

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

This certification is being issued upon request of Mr./Ms. ___________________ for

(Statistical Researcher)
whatever legal intents and purposes it may serve.

Given this ____ day of January 2024 at Barangay _________________________

___________________________________________________________________.

________________________________
Name:
Position:
Date: ___ / ___ / ___
PSA Complex, East Avenue, Diliman, Quezon City, Philippines 1101
Telephone: (632) 8938-5267
www.psa.gov.ph