SK of Barangay __, _________

City/Municipality of __________
Province of _______________

SK CHAIRPERSON’S CERTIFICATION (SKCC)

SKCC No.: ________________

Date: .

To: The BANK MANAGER

Development Bank of the Philippines
Laoag City Branch

Sir/Madam:

This is to certify that the following checks were duly issued by SK of Brgy. 1, Poblacion, Pasuquin, I.N.
(Ito ay nagpapatunay na ang mga tseke na nakalista sa ibaba ay na-isyu ng SK ng Brgy. 1, Poblacion, Pasuquin, I.N.

complete with respective Disbursement Vouchers and supporting documents.

na kumpleto ng kani-kanilang Disbursement Vouchers at kalakip na mga dokumento.)

Account No. Check No. Date Payee Amount Purpose

The undersigned attests to the truthfulness of the foregoing facts, under pain of liability for falsification,
(Pinapatotohanan ng may lagda ang mga nakasaad sa itaas batid ang pananagutan sa kasong “Falsification”,

pursuant to Article 171(4) of the Revised Penal Code of the Philippines.

sang-ayon sa Artikulo 171(4) ng Revised Penal Code ng Pilipinas.)

Very truly yours,

(printed name)
SK Chairperson

Delivered by: Received by:

(printed name) ____________________________

SK Treasurer ____________________________
Date: (date) ____________________________