Minday Bambang

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FORM TYPE: Travel Coordination Permit

QR: LGU-AC66DCD6712374-02-27

NAME: Minday Bambang

Traveller Type: Returning Residents

Origin: IBA, ZAMBALES

Origin BRGY: Zone 1

STATUS: APPROVED Destination: ROXAS CITY, CAPIZ

Destination BRGY: Punta Tabuc

Date of Travel: 2022-03-02

Date of Expected Arrival: 2022-03-02

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CAPIZ, REGION VI WESTERN VISAYAS

Date: February 27, 2022

Travel Coordination Permit

This travel coordination permit is granted to the person listed below to pass at the established
Quarantine Control Points (QCPs), Checkpoints, Seaports and Airports from point of origin to point of
destination.

Name: Minday Amesa Bambang

Type of Traveller: Returning Residents

Date of Travel: March 2, 2022 to March 2, 2022

Place of Origin: IBA, ZAMBALES

Origin Barangay: Zone 1

Place of Destination: ROXAS CITY, CAPIZ

Destination Barangay: Punta Tabuc

Mode of Transportation: Air (public)

Additional Travel Details: BD8 IT TC

Remarks: NA

Last Update: 2022-02-27 07:50:31

WARNING: Falsification of S-PaSS travel documents, medical certificates, including COVID-19 test results and vaccination
cards is punishable with imprisonment and fines under the Revised Penal Code as well as Republic Act 11332 or the
Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act.

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JUDY GRACE C. PELAEZ, PDRRMO CAPIZ