Immaculate Heart of Mary Parish

Kitcharao, Agusan del Norte

8609 Philippines

CERTIFICATION OF NO RECORD

TO WHOM IT MAY CONCERN:

This is to certify that Mr. /Ms. ________________________son ____________________

daughter of __________________________ solemnly baptized in our Catholic Church but
his/her record does not appear in our BAPTISMAL Book.
The reason for no record in our baptismal book might be the fact his/her misplaced, not
reported, or might had been lost at all.
This certification is being issued upon the request of ____________________________
for whatever legal purposes it may serve.
Done this _____________ day of __________ 20 ____ at the Immaculate Heart of Mary
Parish, Kitcharao, Agusan del Norte, Philippines.

________________________________
Parish Priest

Not valid without

Parish seal