Republic of the Philippines

Province of Samar
Municipality of Marabut
BARANGAY FERRERAS

OFFICE OF THE PUNONG BARANGAY

CERTIFICATE OF INDIGENCY

TO WHOM IT MAY CONCERN:

This is to certify that _______________, of legal age, male/female,

single/married/widow/widower, Filipino citizen, with residence at Purok
__________, Barangay Ferreras, this Municipality, whose specimen signature
appears below, is an INDIGENT and that he/she has visibly no money, property, or
means of livelihood sufficient and available for daily food, shelter, and basic
necessities for himself/herself and his/her family.

This certification is being issued upon the request of the above-named person
for whatever legal purpose it may serve him/her.

Issued this ___ day of _______, 2023, at Barangay Ferreras, Marabut,

Samar, Philippines.

Specimen Signature:

__________________

HON. BILLY BOY O. CABERO

Punong Barangay