DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

FIELD OFFICE II
#2 Dalan na Pagayaya, Regional Governen! Cen!er,
Carig, T"g"egarao Ci!y
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PANTAWID PAMIL<ANG PILIPINO PROGRAM
(Date of Issuance)
CERTIFICATION
This is to certify that as of (October 31, 2012), the total amount of (amount in words and in figures, representing cash grants for (PAYROLL PERO!) was not paid and to be rescheduled for
the succeeding periods. The details of unpaid beneficiaries for rescheduling are as follows:
LIST OF UNPAID BENEFICIARIES