Republic of the Philippines

OFFICE OF THE PUNONG BARANGAY

Barangay Caglanipao Sur
Calbayog City

MAGNO C. PRUDENCIADO BARANGAY CLEARANCE

Punong Barangay

TO WHOM IT MAY CONCERN:

Kagawad
Julius C. Lingling This is to certify that Mr./Ms. _____________________, ____ years
Bernard P. Peraan old, Filipino, and Married/Single/Widow whose recent photograph,
Randy R. Nabor signature, and thumb mark appears herein is a resident of
Rigen L. Derman BARANGAY CAGLANIPAO SUR, CALBAYOG CITY since _____ up
Diolita T. Rollo to present.
Genalyn M. Gallo
This further certifies that this Office has no record that he/she has
Eva L. Prudenciado
engaged in any unlawful activity nor has she have been convicted for
violation of any existing laws and ordinance of this Barangay.
This certification is issued upon the request of subject person for
the Purpose: ______________________
Romel G. Mekitpekit
Issued this _____ day of ___________, 20___ at the Office of the
SK Chairperson
Punong Barangay Caglanipao Sur, Calbayog City.

Rubelyn A. Ablazo
Barangay Secretary

Jenalyn N. Tapaya Print Name & Signature Right Thumb mark

Barangay Treasurer
 MAGNO C.
PRUDENCIADO
Punong Barangay

CTC No: __________________

Dated: _____________
NOT VALID WITHOUT SEAL. Valid only for six (6) months from date of issuance.