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Republic of the Philippines

Province of Samar
Municipality of Marabut

OFFICE OF THE PUNONG BARANGAY

THIS IS TO CERTIFY that the employee/official whose name, position, designation and office given
below has appeared in this office, business establishment during the period and for the purpose stated
hereunder.

NAME: _______________________________________________________________________

Position/ Designation: __________________________________________________________

Agency/ Office: _______________________________________________________________

Date/s (Inclusive): _____________________________________________________________

Purpose is (State Briefly): ______________________________________________________

____________________________________________________________________________

__________________________

__________________________

Republic of the Philippines


Province of Samar
Municipality of Marabut

OFFICE OF THE PUNONG BARANGAY

THIS IS TO CERTIFY that the employee/official whose name, position, designation and office given
below has appeared in this office, business establishment during the period and for the purpose stated
hereunder.

NAME: _______________________________________________________________________

Position/ Designation: __________________________________________________________

Agency/ Office: _______________________________________________________________

Date/s (Inclusive): _____________________________________________________________

Purpose is (State Briefly): ______________________________________________________

____________________________________________________________________________

__________________________

__________________________

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