Republika ng Pilipinas

Lalawigan ng Bulacan
Bayan ng San Ildefonso
TANGGAPAN NG PUNONG BARANGAY
Sangguniang Barangay ng Bulusukan

BULUSUKAN
BARANGAY OFFICIALS
BARANGAY CLEARANCE
AILYN S. CALDERON
Brgy. Captain
To whom it may concern:
GERRY T. IGNACIO
Brgy. Councilor
This is to certify that the person whose name and signature print appear hereon
has requested a RECORD CLEARANCE from this office and the result are listed below:
JOSE S. VALMOCINA JR.
Brgy. Councilor

Name: ________________________________________
MIGUEL J. HIZON
Brgy. Councilor Status: __________
Address: BULUSUKAN SAN ILDEFONSO, BULACAN
REYNOLD R. CORREA
Brgy. Councilor Birthday: __________________
Citizenship: __________________
LEO V. JOSON
Brgy. Councilor Nature of Residency: BONAFIDE

Date of issue: __________________________

ROSE N. MARCOSO
Brgy. Councilor Place of issue: MULTIPURPOSE HALL, BULUSUKAN, SAN ILDEFONSO,
BULACAN
JECIMAE E. CORREA
Brgy. Councilor
This further certifies that he/she is personally know to me with honesty and
strength of good moral standing he/she has NO DEROGATORY record of information
KYLE ANDREI S. CALDERON
SK Chairman filed in this office.

RYAN C. CALDERON
Secretary
_____________
Signature
LIELANI C. DE GUZMAN
Treasurer AILYN S. CALDERON
Barangay Captain
(Not valid without Barangay Dry Seal)