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FORM MP6SEKAHJD
Tuesday Feb 28, 2023 AM ()
Valid Until Mar 15, 2023
APPLICANT TYPE 1. ID PRESENTED 2. PURPOSE TYPE 3. PURPOSE APPLICATION
NEW VOTERSID|5810-0106B-AO883MBT20000 LOCAL MULTI-PURPOSE CLEARANCE
BASIC INFORMATION
PARENTS INFORMATION
28. NAME OF FATHER 29. FATHER BIRTH PLACE
ROGELIO TENDENCIA LAGUNA
I certify that I have read and understood all the questions set forth in this application and answer I have furnished on this form are true and correct to the best acknowledge and belief. I understand that any false or
misleading statement is FALSIFICATION PUNISHABLE UNDER ARTICLE 171 & 172 OR REVISED PENAL CODE
________________________________ ________________________________
https://clearance.nbi.gov.ph/print 1/1