REPUBLIC OF THE PHILIPPINES

PROVINCE OF LEYTE
MUNICIPALITY OF

OFFICE OF THE PUNONG BARANGAY

CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO single, Filipino and a permanent resident of which was included in the areas
declared under a state of calamity due to tropical storm/ typhoon Ursula.

This is to certify further that intense rain and wind had occurred in our barangay which
caused flooding and damage to the dwelling of the residents, necessitating them to conduct urgent
repair and clean-up of the fallen debris and minor damages caused to their houses.

Moreover, due to the adverse weather brought by the calamity, incurred pneumonia and
upper respiratory tract infection; thus, she was not able to go to work on the days of
emergency/calamity leave applied for.

This Certification is issued for all legal purposes or intents it may serve her.