Republic of the Philippines

NAME Province of Cebu

Barangay Captain City of Naga
BARANGAY EAST POBLACION
Barangay Councilmen & Email address
Committee Chairmanship TIN No:

NAME OFFICE OF THE PUNONG BARANGAY

Committee on

NAME
Committee on

NAME
Committee on

BARANGAY CLEARANCE
NAME
Committee on TO WHOM IT MAY CONCERN:
This is to certify that ________________________________,
_____ years of age, single/married/widow/widower, Filipino, is a bona
fide resident of Purok _________________________ in this Barangay,
NAME
and who is personally known to me with good moral character and a
Committee on
law-abiding citizen of this community.

This certify further that he/she has not committed, nor been
involved in any kind of unlawful or illegal activities in this barangay.
NAME
Committee on This certification is hereby issued upon the request of
Mr./Ms./Mrs. ______________________________________ to
support his/her request or application for:

NAME ( ) Overseas Employment ( ) School Purposes

Committee on ( ) Local Employment ( ) Building Permit
( ) Police Clearance ( ) Travel
( ) Postal I.D. ( ) Fencing Permit
( ) Electrical Connection ( ) SSS/Philhealth/PAG-IBIG
NAME ( ) Business Permit ( ) Animal Bite Vaccination
Committee on ( ) Water Connection ( ) Others: ___________________

Issued this ____ day of ________________, _____ at

Barangay _____________, City of Naga, Cebu.

NAME
Committee on
_________________________ NAME
Applicant’s Signature Barangay Captain