REPUBLIC OF THE PHILIPPINES

PROVINCE OF LA UNION
MUNICIPALITY OF SAN GABRIEL
BARANGAY LACONG

REPUBLIC OF THE PHILIPPINES

Office of the Punong Barangay
PROVINCE OF LA UNION
MUNICIPALITY OF SAN GABRIEL
BARANGAY LACONG

To whom it may concern; Office of the Punong Barangay

This is to certify that

______________________________________________________
To whom it may concern;
___________________________________.

This certification was issued upon the request of the subject person f
Thispurposes.
any legal intents and is to certify that JANE G.GALLARDE, 25 years old
this barangay for a period of 25 years. This further certifies tha
to me as a person of good moral character,law abiding citizen a
been listed her name on Drug List in our Municipality and has n
Issued this ___ day of ___,2021 at Brgy. Lacong San Gabriel La Union.
violated any law, ordinance or rule duly implemented by the go
authorities.

This certification was issued upon the request of the subj

any legal intents and purposes.
DOMINADOR A.
Punong Barangay

Issued this June day of 28th,2021 at Brgy. Lacong San Gabriel

___________________
Signature/Thumbmark

OR Number: DOM
CTC Number:___________ Pun
Issued on:_____________
Issued at: Brgy. Lacong, San Gabriel La Union
Amount: 50.00