Document Code

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT FM-SP-DILG-07-01

CITIZEN'S CHARTER SERVICE REQUEST FORM Rev. No. Eff. Date
06.15.21
Page
of 1 1
00

SERVICE TITLE: PROCESSING OF BARANGAY OFFICIALS DEATH AND BURIAL REFERENCE NO. DBC-R3-TAR-LP-2024-07-03-001
ASSISTANCE (BODBA) FOR FUND ALLOCATION BY THE DEPARTMENT OF BUDGET DATE OF REQUEST xx/xx/xxxx
AND MANAGEMENT (DBM)
NAME OF CLIENT/ORGANIZATION:
Documentary Requirements Kindly Check the Rolando M. De Guzman
(as of January 1, 2024) Documents Needed
1. Oath of Office / CONTACT DETAILS:
2. Certificate of Assumption to Office (applicable to 2023-
2025 term of office) x

3. Certification that the barangay official was incumbent at

the time of his/her death (issued by the DILG C/MLGOO or x
Punong Barangay)
4. Certified true copy of the death certificate of the deceased
barangay official /

5. Photocopy of any valid government-issued ID of the OTHER NEEDED INFORMATION, if any:

claimant /

Claimant’s documents whichever is applicable: Original Relationship to the DBO:

or Certified True Copy

a.) Marriage Certificate, if the claimant is the

widow/widower of the deceased barangay official /

b.) Birth Certificate of the deceased barangay official, if the SIGNATURE:

claimant is the parent of the deceased barangay official n/a

c.) Birth Certificate of the claimant, if son/daughter or

brother/sister of the deceased barangay official n/a
RECEIVED BY: DATE AND TIME RECEIVED

d.) A Special Power of Attorney, which shall be executed as

supporting document in the case of multiple designated
beneficiaries/claimants of deceased barangay officials,
except if the claimant is spouse. Only one check shall be n/a
issued to the person whom the beneficiaries agreed from
among themselves to receive the check

e) A designated beneficiary/legal heir who is a minor shall be

represented by a guardian. An affidavit of Guardianship shall
be executed for the purpose

f.) In the absence of primary and secondary beneficiaries/ n/a

claimants, an affidavit of two (2) interested persons or
affidavit of self-adjudication shall be executed by the
claimant to support that he/she is the only heir of the
deceased barangay official

g.) If the claimaint is the Common-Law Spouse/Parent of the Receiving Officer

deceased barangay official, the legal heir shall execute an n/a
Affidavit or Special Power of Attorney ENDORSED TO RESPONSIBLE OFFICER: DATE AND TIME ENDORSED

Other supporting documents:

h) Photocopy of Police Report, in case the matter of death of

the deceased barangay official is not a natural cause n/a

i) Affidavit of two (2) disinterested parties shall be executed

if there is a discrepancy in the name of the deceased n/a
barangay official or claimant

j) For beneficiaries of IPMRs, if applicable, in the absence of

the documents mentioned above, affidavit of two (2) n/a
disinterested persons shall be required

k) other supporting documents n/a

REMARKS:
Name/Unit and Designation
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ACKNOWLEDGEMENT RECEIPT
This is to acknowledge the service/s you have requested: REFERENCE NO.
Service Title: Processing of Barangay Officials Date Received Expected Date of Release Date of Release in
Death and Burial Assistance (BODBA) For Fund case of extension
Allocation By The DBM Republic of the Philippines
DEPARMENT OF THE INTERIOR AND LOCAL GOVERNMENT

NAME OF RESPONSIBLE OFFICER/UNIT/DESIGNATION: CONTACT DETAILS:

OFFICE ADDRESS:

REMARKS:
 Document Code
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT FM-SP-DILG-07-01
CITIZEN'S CHARTER SERVICE REQUEST FORM Rev. No. Eff. Date
06.15.21
Page
of 1 1
00

SERVICE TITLE: PROCESSING OF BARANGAY OFFICIALS DEATH AND BURIAL REFERENCE NO. DBC-R3-TAR-BAM-2024-07-11-001
ASSISTANCE (BODBA) FOR FUND ALLOCATION BY THE DEPARTMENT OF BUDGET DATE OF REQUEST xx/xx/xxxx
AND MANAGEMENT (DBM)
NAME OF CLIENT/ORGANIZATION:
Documentary Requirements Kindly Check the Marites T. Gabriel
(as of January 1, 2024) Documents Needed
1. Oath of Office / CONTACT DETAILS:
2. Certificate of Assumption to Office (applicable to 2023-
2025 term of office) N/A

3. Certification that the barangay official was incumbent at

the time of his/her death (issued by the DILG C/MLGOO or /
Punong Barangay)
4. Certified true copy of the death certificate of the deceased
barangay official /

5. Photocopy of any valid government-issued ID of the OTHER NEEDED INFORMATION, if any:

claimant /

Claimant’s documents whichever is applicable: Original Relationship to the DBO:

or Certified True Copy

a.) Marriage Certificate, if the claimant is the

widow/widower of the deceased barangay official

b.) Birth Certificate of the deceased barangay official, if the SIGNATURE:

claimant is the parent of the deceased barangay official

c.) Birth Certificate of the claimant, if son/daughter or

brother/sister of the deceased barangay official RECEIVED BY: DATE AND TIME RECEIVED

d.) A Special Power of Attorney, which shall be executed as

supporting document in the case of multiple designated
beneficiaries/claimants of deceased barangay officials,
except if the claimant is spouse. Only one check shall be
issued to the person whom the beneficiaries agreed from
among themselves to receive the check

e) A designated beneficiary/legal heir who is a minor shall be

represented by a guardian. An affidavit of Guardianship shall
be executed for the purpose

f.) In the absence of primary and secondary beneficiaries/

claimants, an affidavit of two (2) interested persons or
affidavit of self-adjudication shall be executed by the
claimant to support that he/she is the only heir of the
deceased barangay official

g.) If the claimaint is the Common-Law Spouse/Parent of the Receiving Officer

deceased barangay official, the legal heir shall execute an
Affidavit or Special Power of Attorney ENDORSED TO RESPONSIBLE OFFICER: DATE AND TIME ENDORSED

Other supporting documents:

h) Photocopy of Police Report, in case the matter of death of

the deceased barangay official is not a natural cause

i) Affidavit of two (2) disinterested parties shall be executed

if there is a discrepancy in the name of the deceased
barangay official or claimant

j) For beneficiaries of IPMRs, if applicable, in the absence of

the documents mentioned above, affidavit of two (2)
disinterested persons shall be required

k) other supporting documents

REMARKS:
Name/Unit and Designation
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ACKNOWLEDGEMENT RECEIPT
This is to acknowledge the service/s you have requested: REFERENCE NO.
Service Title: Processing of Barangay Officials Date Received Expected Date of Release Date of Release in
Death and Burial Assistance (BODBA) For Fund case of extension
Allocation By The DBM Republic of the Philippines
DEPARMENT OF THE INTERIOR AND LOCAL GOVERNMENT

NAME OF RESPONSIBLE OFFICER/UNIT/DESIGNATION: CONTACT DETAILS:

OFFICE ADDRESS:

REMARKS: