TO WHOM IT MAY CONCERN,

THIS IS TO CERTIFY THAT, of legal

age. Filipino, ( ) male ( ) female, ( ) single ( ) married ( ) widow, whose recent photograph,
signature and thumb mark appears herein is a resident of Barangay Calasag, Municipality of
San Ildefonso, Province Of Bulacan. Subject person has NO DEROGATORY RECORD
ON FILE and with good family standing in the community.

This certification is being issued upon the request of the bearer to satisfy requirement
and for the purpose stated below.

PURPOSE: Any Legal Purposes

Given this day of ______________________ 2023,at office of Barangay

Chairman, Barangay Calasag, San Ildefonso, Bulacan.

Voter’s ID No. :
SSS No.:
Date of Birth : Thumb Print

Place of Birth :__________________

Signature of the Subject Person

HON. EDMUNDO A. GONZALES

Barangay Chairman
NOT VALID WHITHOUT DRY SEAL.VALID FOR 60 DAYS,NON TRANSFERABLE