Republic of the Philippines

Province of Tarlac
Municipality of La Paz
BARANGAY COMILLAS

OFFICE OF THE PUNONG BARANGAY

CERTIFICATE OF GUARDIANSHIP

Name: PERLA PEREJAS AGAD (Legal Guardian)

Date of Birth: May 08, 1953
Present address: Comillas, La Paz, Tarlac

Guardian Name in full: CONSUELO DIZON AGAD

Date of Birth: March 13, 1934
Present address: Comillas, La Paz, Tarlac

I, PERLA PEREJAS AGAD. (Daughter in Law) hereby declare to take on the full
responsibility, guardianship and support for CONSUELO DIZON AGAD (Mother in Law)
bonafide resident of Barangay Comillas, La Paz, Tarlac as her legal guardian.

I further declare that all communication and supervision shall be my sole responsibility.

As guardian, I shall be the primary contact and shall take all legal and financial responsibilities
for the supervision.

Sincerely,

PERLA PEREJAS AGAD

Subscribed and sworn to before me this 06th day of April, 2022 at Barangay Comillas,
La Paz, Tarlac

NOTED:

PABLO B. PINEDA
Punong Barangay