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  • BOEform 1 B Apr 2012

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    jamjayjames3208
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    This document is a certification form for appointive barangay officials to document their service in a particular barangay. It requires information such as the official's name and position, dates of appointment, dates served, and the appointing punong barangay's name and term. The certification is issued to support applications for barangay official eligibility and must be signed by an authorized DILG official on official letterhead with a DILG seal affixed.

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    BOE Form

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    BOEform1bApr2012

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    This document is a certification form for appointive barangay officials to document their service in a particular barangay. It requires information such as the official's name and position, dates of appointment, dates served, and the appointing punong barangay's name and term. The certification is issued to support applications for barangay official eligibility and must be signed by an authorized DILG official on official letterhead with a DILG seal affixed.

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    Attribution Non-Commercial (BY-NC)
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    83 views2 pages

    BOEform 1 B Apr 2012

    Uploaded by

    jamjayjames3208
    This document is a certification form for appointive barangay officials to document their service in a particular barangay. It requires information such as the official's name and position, dates of appointment, dates served, and the appointing punong barangay's name and term. The certification is issued to support applications for barangay official eligibility and must be signed by an authorized DILG official on official letterhead with a DILG seal affixed.

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    of 2

    CSC-ERPO BOE Form 1(b), April 2012

    CERTIFICATION on Services Rendered in the Barangay*


    (Appointive Official)

    This is to certify that (complete name of the Barangay official) has rendered services in Barangay (complete name of the Barangay) , City/Municipality of (complete name of the city or municipality) , Province of (complete name of the province) , with the following details:

    Position Held

    Date of Appointment
    (start from most recent)

    Inclusive Dates of Years Served From


    (mm/dd/yyyy)

    To
    (mm/dd/yyyy)

    No. of Years Served

    Appointing Punong Barangay Name Date Elected Term of Office


    (no. of years)

    This Certification is issued in support of the evaluation/processing of the application of Mr./Ms. (last name of the Barangay official) for the grant of Barangay Official Eligibility pursuant to Republic Act No. 7160, in accordance with CSC Resolution No. _______________
    (city/munipality and province)

    (complete date)

    ________________________________
    (Signature over full printed name of Authorized DILG official)

    ________________________________
    (Complete position title of the signatory)

    *To be printed in DILG official letterhead, and affixed with DILG Dry Seal at the portion covering the signature over printed name of the authorized DILG official.

    /erpo.psd.mlgr.lqc.gpl.masfm.032712.a

    Page 1 of 2

    Notes: 1. The Certification on Services Rendered in the Barangay of Appointive barangay officials shall be signed by the authorized DILG Official at the municipal, city, provincial, or regional level. It shall be printed on official letterhead of the DILG issuing Office, and affixed with DILG Dry Seal at the portion covering the signature over printed name of the authorized DILG official. 2. Complete name of the Barangay Official shall refer to First Name, Middle Initial, Last Name, and Extension Name, if any. 3. Appointive Barangay Officials include Barangay Treasurers, and Barangay Secretaries who were appointed by the duly elected Punong Barangay. 4. The From and To columns shall be written numerically in the month-day-year format. 5. All previous appointments/services (other than the current/most recent) rendered by the appointive barangay official under similar position in the same barangay must also be indicated.

    /erpo.psd.mlgr.lqc.gpl.masfm.032712.a

    Page 2 of 2

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