Brgy. Fee: P25.

00
OR. No.: 123456789
Date: January 4, 2021

Republic of the Philippines

Province of Antique Signature of Affiant:
Municipality of Laua-an CTC No. 00112223333
BARANGAY GUINBANGA-AN Issued at Laua-an, Antique
on January 4, 2021
OFFICE OF THE PUNONG BARANGAY

HON. JUANITO S. MARFIL

Barangay Clearance
Barangay Captain

HON. SIXTO LOMUGDA

Barangay Councilor
Chairman, Committee on
Appropriations

HON. OSCAR JUAYNO TO WHOM IT MAY CONCERN

Barangay Councilor
Committee on Infrastructure This is to certify that
HON. CYNTHIA DALIMOCON

ELNEST T. BANTOLO
Barangay Councilor
Committee on Health and Education

HON. JAYLORD LOMUGDANG

Barangay Councilor
Committee on Lights
of legal age, Filipino Citizen whose signature, CTC Number, place
HON. GERALD BAYLON and date of issue appear below is a bonafide resident of the
Barangay Councilor
Committee on Peace and Safety barangay herein above written.
HON. SUNDAY LEGARIO
Barangay Councilor
This is to certify further that according to the records filled in this
Committee on Ways and office, he/she is a law-abiding citizen having NO CRIMINAL
Means/Agriculture RECORD nor any PENDING CASE of whatsoever as of this date.
HON. ISAMIRA BUOT
SK Chairperson This certification is being issued upon the request of the herein
Committee on Sports interested party or whatever legal purpose it may serve.
MRS. EDITHA PACLIBAR
Barangay Treasurer Given this 16th day of August 2018 at Guinbanga-an, Laua-an,
TEDDY BANTOLO
Antique, Philippines.
Barangay Secretary

MR. ADRESITO BANDIOLA

Barangay Chief Tanod

JUANITO S. MARFIL
Barangay Captain