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. LINA JUAYNO TO WHOM IT MAY CONCERN

Committee Against Women and
Children This is to certify that
HON. OSCAR JUAYNO

ELNEST T. BANTOLO
Barangay Councilor
Committee on Infrastructure

HON. CYNTHIA DALIMOCON

Barangay Councilor
Committee on Health and Education
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 Agriculture barangay herein above written.
HON. SUNDAY LEGARIO This is to certify further that according to the records filled in this
Barangay Councilor
Committee on Ways and Means/Lights office, he/she is a law-abidingcitizen having NO CRIMINAL
RECORD nor any PENDING CASE of whatsoever as of this date.
HON. JOHNNY DUBRIA
Committee on Peace and Order
This certification is being issued upon the request of the herein
HON. ROWELYN GRACE LAVEGA interested party or whatever legal purpose it may serve.
SK Chairperson
Committee on Sports
Given this 16th day of August 2018 at Guinbanga-an, Laua-an,
MRS. EDITHA PACLIBAR Antique, Philippines.
Barangay Treasurer

TEDDY BANTOLO
Barangay Secretary

MR. ADRESITO BANDIOLA

Barangay Chief Tanod JUANITO S. MARFIL
Barangay Captain