Republic of the Philippines

Province of Agusan del Sur

SAN FRANCISCO WATER DISTRICT
Osmeña St, Barangay 2, San Francisco
sanfranzwd@yahoo.com

CERTIFICATE OF APPEARANCE
To whom it may concern:

This is to certify that the person whose name stated hereunder appeared in this office.

Name: ____________________________________________________________________
Designation: ____________________________________________________________________
Station: ____________________________________________________________________
Date Appeared: ____________________________________________________________________
Purpose: ____________________________________________________________________

Issued this ______ day of ___________________, 2021 at San Francisco, Agusan del Sur.

ELMER T. LUZON
General Manager