Republic of the Philippines

Province of Eastern Samar

Municipality of Arteche

CERTIFICATION
This is to certify that the following names of Household Head have been
assessed in accordance with the DSWD Assessment Tool to be Financially incapable.

No. First Name Middle Name Last Name Birthdate Place of Birth
1 Ramon Derilo Ellado
2 Jerwin Pasquil Pajares
3 Edmar Badando Gerbon
4 Mamerto Pimentel Gerbon
5 Elena Orsal Lopega
6 Roberto Quimada Quitorio
7 Reina Maestre Quitorio
8 Salvador Logon Aucilia
9 Jovannie Nebril Aucilia
10 Jonathan Recoy Ravas
11 Narciso Picardal Baladad
12 Liza Norcio Baleña
13 Rosemarie Burac Lomuntad
14 Jun Ortiz Lomuntad
15 Nelia Lagumbay Balagoplo
16 Honeybee Borja Flores
17 Amado Tedranes Lira
18 Rosie Lomuntad Godines
19 Elena Rongcales Pajares
20 Joylen Pajares Norcio
21 Ruby Operario Picardal
22 Adeliada Tedranes Lomiares
23 Jayson Ortillada Rosco
24 Jessa Pimentel Gerbon
25 Melbin Ortillada Picardal
26 Rinalyn Burac Lomuntad
27 Karen Pinangay Gerbon
28 Niel Anthony Manimtim Osias
29 Maria Victoria Pinangay Gerbon
30 Welven Capito Mengote
31 Leonila Tedranes Lira
32 Roman Logon Acol
33 Jonnel Mendosa Amango
34 Lolita Picardal Colico
35 Warren Matalipne Añasco
36 Jeffrey Adel Baldomero
37 Welfredo Norcio Baleña
38 Norma Norcio Baleña
39 Joseph Eljera Baleña
40 Aurora Pajares Norcio
41 Nena Lucana Orsal
42 Francisco Rosco Pajares
 43 Gleceria Piandiong Orosco
44 Magdalena Voces Pajanustan
45 Arnel Voces Pajanustan
46 Concepcion Pajaroja Quimada
47 Celso Ortillada Rosco Jr.
48 Clariss Burac Solidon
49 Antonio Burac Solidon
50 Mar Dolem Rosco
51 Rodrigo Rosco Chinel
52 Jonalyn Pinangay Gerbon
53 Jerwin Pasquil Pajares

This certification is issued for the purpose of availing Philhealth benefits by the above
name indigents or his/her declared dependent/s according to the provision of the
General Appropriation Act 2020.

Issued on March _____ , 2020 at Arteche, Eastern Samar.

Certified by:

JUDITH O. POMBO
Social Welfare Officer
License No. 0010979

Conformed:

ROLAND BOIE M. EVARDONE, RN

Municipal Mayor