Republic of the Philippines

Province of Romblon
MUNICIPALITY OF ROMBLON
BARANGAY CAPACLAN
--oo0oo--
OFFICE OF THE PUNONG BARANGAY

CERTIFICATION

This is to certify that ________________________________________________________ and

(Name in Birth Certificate/ID)
_______________________________________________________ , of legal age, a
(Name in Payroll/ Notification form) (Age)
bonafide resident of Sitio ______________________________, Barangay Capaclan, Romblon,
Romblon is the SAME PERSON.

This certificate is being issued upon the request of the Mr./ Mrs./ Ms.
__ ___________________________ __ for ANY LEGAL PURPOSE, this __5TH _
(Correct Name) (Date)

of ____NOVEMBER___, 2022 at Barangay Capaclan, Romblon, Romblon, Philippines.

(Month)

Signed:

HON. NILDA M. MADURO

Punong Barangay

Not valid without dryseal

Address: Gov. Fetalvero Ext., Sitio Centro, Capaclan, Romblon, Romblon, 5500 Phils.