Republic of the Philippines

Province of Isabela
MUNICIPALITY OF SAN MARIANO
Barangay San Jose

OFFICE OF THE PUNONG BARANGAY

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that Mr./Mrs. __________________, _____ years of age,

(Single/Married/Widowed/Separated), Filipino citizen and a bonafide resident of ______
Barangay San Jose, San Mariano, she/he is known to us with a Good Moral character,
law abiding citizen in the community. She/He has NO CRIMINAL RECORD filed against
him/her as per records on file with thus office as of this date.

This certification is issued on accordance to the implementation of the provision

of the New Local Government Code of 1991 and whatever legal purpose it may serve
best.

Issued this ______ day of ____________2019 at Barangay San Jose, San

Mariano, Isabela.

FLORENTINO R. BUÑAO
Punong Barangay

Comm. Tax Cert. No : ________________________

Place of Issue : San Jose, San Mariano, Isabela
Date Issued : ________________________
OR Number : ________________________