Republic of the Philippines

Province of _________
Municipality of _________
BARANGAY ________________

Office of the Punong Barangay

_________________________________________________________________________

CERTIFICATE TO TRAVEL

TO WHOM IT MAY CONCERN:

This is to certify that _________________________________________ of legal and a

resident of Barangay _______________, Municipality of _________, Province of __________, that

he/she is authorized to travel outside the barangay to _______________________________ for the

purpose of:

________ to buy food supplies/ grocery

________ purchase of medicine

________ access health care services

________ access banks

______ others:___________________________________

This CERTIFICATION is being issued upon the request of the above-named person for the

purpose mentioned above.

Given this __________ day of ___________________________________ at Barangay

_______________, Municipality of _________, Province of __________,

_____________________

Punong Barangay

Not valid without seal