Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

Lalaguna Mobo.
Province of Masbate

To whom it may concern:

CERTIFICATE OF RESIDENCY AND

SOURCE OF INCOME/LIVELIHOOD

THIS IS TO CERTIFY that JANN CARLO A. COLUMNA, single, of legal age, a bonafide resident of
Barangay Lalaguna, Mobo Masbate.

That the above mentioned is currently unemployed and have no source of income.

This certification is being issued upon the request of the above mentioned as a requirement for
the issuance of the Certificate of Exemption for Scholarship and Job/Livelihood Programs. Issued
this _________ day of ________________ at ____________________________________.

___________________________
Punong Barangay