Living beneficiary

Republic of the Philippines

Province of
Municipality of
Barangay
-o0o-

CERTIFICATION

2X2

Signature

THIS IS TO CERTIFY that _______, years old

(Name) (Age)
, whose picture and signature appears above, is a bonafide resident of this
(Civil Status)
Barangay. That he/she is the _____ and currently the custodian
(Relation to senior citizen)

/caretaker of .
(Name of the senior citizen)

That he/she is being authorized by the social

(Name of the senior citizen)
Pension beneficiary, to claim the stipend from the social pension program for and his/her behalf.

This certification is issued for whatever purpose it may serve.

Issued this day of , 2023.

Punong Barangay