Republic of the Philippines

Province of Davao de Oro

Municipality of Monkayo
BARANGAY SALVACION
OFFICE OF THE PUNONG BARANGAY

BARANGAY CLEARANCE
This is to certify that the person whose name and picture appearing below
BARANGAY requested for a clearance and the result are as follows:
OFFICIALS -------------------------------------------------------------------------------------------------------------
FAMILY NAME : BACOL

HON. OTHELIO B. SUMATRA FIRST NAME : LIEZLE LEY

Punong Barangay MIDDLE NAME : AMANDORON
BARANGAY KAGAWAD BIRTHDATE : APRIL 11, 1995
HON. REY S. BARA PLACE OF BIRTH : SALVACION, MONKAYO, DAVAO
Committee On Peace & Order
ADDRESS : PUROK 6, SALVACION, MONKAYO, DAVAO DE ORO
HON. ALVIN S. PACULANANG
CIVIL STATUS : SINGLE
SR.
Committee On Environment GENDER : FEMALE

PURPOSE : FOR RENEWING BANK ACCOUNT

HON. NESTOR M. LEOPARDAS
Committee On Finance REMARKS : NO DEROGATORY RECORD ON FILE

HON. BERNARDINA M. Issued this 25TH day of AUGUST 2021 at the Office of the Punong Barangay,
GANTALAO Salvacion, Monkayo, Davao de Oro, Philippines.
Committee on Health

HON. GLORIA E. TOBIAS

Comm. On Prk. Affairs/ Women & Children
& Agriculture

HON. EDILBERTO A. ASIO

Committee On and Infrastructure

HON. ALBERTO P. CALIJAN

Committee On Transportation
Official Receipt No. :
HON. JERECK A. ESLAIS Amount Paid : 70.00 OTHELIO B. SUMATRA
SK Chairperson Transaction Date : 08/25/2021 Punong Barangay
CTC/ Cedula No. : “For and by the authority of the Punong
HON. LUIS L. AGUSTIN CTC Date Issued Barangay’’
: 08/25/2021
IPMR CTC Place Issued : SALVACION
ESTELA D. ASNA Clearance No. : 2021-130
Barangay Secretary BERNARDINA M. GANTALAO
Barangay Kagawad
CHARITA G. CAPACIO
Barangay Treasurer
GILBERT R. BAGUIO
Barangay Record Keeper Applicant Signature
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