Republic of the Philippines

Province of Surigao del Sur

Municipality of Carmen
Barangay Sta. Cruz

OFFICE OF THE BARANGAY CAPTAIN

BARANGAY CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that MRS. ANALYN PLAZA DATOY, of legal age, bona fide
resident of Purok2, Barangay Sta. Cruz, Carmen, Surigao del Sur.

She is known to me personally as person of good moral character and belongs to indigent
family of this Barangay.

This certification is being issued upon the request of the above mentioned for the Burial
Assistance Requirements for her father FAUSTINO P. PLAZA, who passed away last January
6, 2023, 5:00 a.m. in his residence at Barangay Sta. Cruz, Carmen, Surigao del Sur.

Given this 9thday of January, 2023 at Sta. Cruz, Carmen, Surigao del Sur, Philippines.

PAULITA E. CORREOS
Barangay Captain

ANALYN PLAZA DATOY

Signature over printed name

This document is not valid without SEAL

 Republic of the Philippines
Province of Surigao del Sur
Municipality of Carmen
Barangay Sta. Cruz

OFFICE OF THE BARANGAY CAPTAIN

BARANGAY CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that MR. ROLDAN P. IRIGAN, of legal age, bona fide resident
of Purok 1, Barangay Sta. Cruz, Carmen, Surigao del Sur.

He is known to me personally as person of good moral character and belongs to indigent

family of this Barangay.

This certification is being issued upon the request of the above mentioned for the Burial
Assistance Requirements for her daughter CHRISTEL R. IRIGAN, who passed away last
January 20, 2023, at Madrid District Ospital Madrid, Surigao del Sur.

Given this 24th day of January, 2023 at Sta. Cruz, Carmen, Surigao del Sur, Philippines.

PAULITA E. CORREOS
Barangay Captain

ROLDAN P. IRIGAN
Signature over printed name

This document is not valid without SEAL

 Republic of the Philippines
Province of Surigao del Sur
Municipality of Carmen
Barangay Sta. Cruz

OFFICE OF THE BARANGAY CAPTAIN

BARANGAY CERTIFICATION

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that FAUSTINO P. PLAZA, who passed away last January 6,
2023, 5:00 a.m. in his residence at Barangay Sta. Cruz, Carmen, Surigao del Sur.

This certification is issued upon the request of his daughter MRS. ANALYN P. DATOY
in connection with her application for the registration of death of her father and for whatever
other legal purpose it may serve her best.

Given this 9thday of January, 2023 at Sta. Cruz, Carmen, Surigao del Sur, Philippines.

PAULITA E. CORREOS
Barangay Captain

OR.No: : PAID This document is not valid without SEAL

Amount : ₱ 130.00
Issued on : January 9, 2023
Issued at : Brgy. Sta. Cruz, Carmen, Surigao del Sur

Documentary Stamp Tax

Paid = Ᵽ30.00