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Republic of the Philippines

Province of Leyte
Municipality of Dagami
BARANGAY SAMPAGUITA

OFFICE OF THE PUNONG BARANGAY

CERTIFICATE OF INDIGENCY

TO WHOM IT MAY CONCERN:

This is to certify that, JONELYN COLIMA 22 yrs old, whose signature


appears below is a resident of BRGY. SAMPAGUITA, DAGAMI, LEYTE.
It is further certified that the above – named individual belongs to low/no income
bracket or an indigent family in this Barangay. That upon record of this office, Mr. Dione
Colima is Security Guard, while Mrs. Aileen Flores is unemployed.
This CERTIFICATE OF INDIGENCY is being issued upon the request of Ms. Jonelyn
Colima this 11TH of September 2023 for the purpose of compliance of the application
requirements of the EDUCATIONAL ASSISTANCE.

JONELYN CAJANO COLIMA


Signature over printed name

Certified by:

HON. RODRIGO M. ANIANO


BRGY. CHAIRMAN

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