CERTIFICATE OF ACCEPTANCE

THIS IS TO CERTIFY THAT:

____________________________________________

is a bona fide resident of ___________________ who has complied all the necessary
requirements and documents in line with the DILG guidelines for returning locally stranded
individuals, and is granted access to arrive in the City of _________________ on
_______________.

This Certification is issued as proof that the above-named individual is hereby

accepted to enter in the City of ___________________.

___________________
City Health Officer
and with the Authority of the City Mayor ________________________