Republic of the Philippines

Province of Tarlac
Municipality of Paniqui
Tel. No. (045) 931-3412

BARANGAY CERTIFICATION
August 29, 2023
TO WHOM IT MAY CONCERN:

This
This isis to
to certify
certify that the
the person
person whose
whosename,
name,
HON. BERNARDO A. DAVID picture,
picture, and
and signatures appear hereon,
signatures appear hereon, has
haspassed
passedthethe
Committee on Health
record verification
record verification which
which was
was conducted
conductedbybythis
thisoffice.
office.
Theresult(s)
The result(s) of
of which
whichis/are
is/arelisted below:
listed below:
NAME : SERGIO, SUNSHINE y OASNON
ADDRESS : BLK. 8, LOT 35, ABUNDANCE ST., ALEXANNRE
HEIGHTS SUBD, PUROK 4 SAMPUT, PANIQUI,
TARLAC
DATE OF BIRTH : 10 NOVEMBER 1993
PLACE OF BIRTH : IRIGA CITY
CIVIL STATUS : SINGLE
SEX : FEMALE

Local Employment
Overseas Employment
Loan Purposes
Electrification
Water Line Connection
Others (Specify): Reference Purposes

_____________________________________________
Signature over Printed name

This further certifies that the above-named person has no derogatory/criminal

records filed in this Barangay.

This certification is issued upon the verbal request of the above-named person.

Certified by:
HON. ALBERT B. ROSALES
SK Chairperson
HON. MARIA AGNES J. CHAN
Punong Barangay
ROMINA JOY P. LACAYANGA NOT VALID WITHOUT DRY SEAL
ROMINA JOY P. LACAYANGA CTC No.:07727087 Date / Place Issued 8-25-23-Paniqui, Tarlac
Barangay Secretary
Barangay Secretary

Bawat isa ay kaagapay tungo sa pagunlad ng Barangay”

VIRGILIO S. BULAON
VIRGILIO S. BULAON
Barangay Treasurer
Barangay Treasurer
THIS CLEARANCE IS IN CONSONANCE WITH THE PREVAILING BARANGAY
ORDINANCES, RULES, AND REGULATIONS ARE BEING ENFORCED IN THIS BARANGAY.
VALIDITY: SIX MONTHS FROM THE DATE ISSUED