REPUBLIC OF THE PHILIPPINES

(Municipality)

BARANGAY CLEARANCE

TO WHOM IT MAY CONCERN

This is to certify that (name of business) owned and operated

by (name of owner showing in DTI registration) with business
address located at (business address) , after complying with the
requirements prescribed by this Office, is hereby issued a BARANGAY
CLEARANCE for the purpose of securing a Mayor’s Permit in order to
operate a (nature of business) in accordance with the Barangay
Revenue Ordinance of 2008. However, the Barangay Clearance may be
cancelled or revoked anytime if public safety and interest so
require.

This Barangay Clearance is hereby issued upon request of

(requestor)

Issued this ___ day of (month) , (year).

HON. (BRGY CHAIRMAN)

Punong Barangay