Republic of the Philippines

MUNICIPALITY OF BAUTISTA
Province of Pangasinan

BARANGAY SINABAAN
OFFICE OF THE PUNONG BARANGAY

BARANGAY CLEARANCE

Date: _______________ 20 ______

To Whom It May Concern:

This is to certify that ____________________________a resident of this

Barangay whose signature and community tax certificate appear below is well known to
be a man/woman of good moral character, law abiding and peace loving citizen. He /
she was never prosecuted of any crime whatsoever according to the records of this
office.

This certification is issued to ________________________________ for whatever

any legal purpose it may serve.

____________________ ELVIRA F. MARTINEZ

Signature Punong Barangay

Community Tax Cert. No. ___________

Issued at ________________________
On _____________________________