Republic of the Philippines

Province of Apayao
Municipality of Conner
BARANGAY CUPIS

OFFICE OF THE TROBAL LEADER/PUNONG BARANGAY

CERTIFICATION

TO WHOM IT MAY CONCERN;

This is to certify that ________________________________________,_________ of

age,___________

Bona fide resident and belongs to the indigent family in the barangay.

This further certifies that the family’s livelihood activities as source of their income could not fully
supplement their daily basic needs, thus they are in crisis situation and eligible for assistance.

This certification being issued for the purpose of seeking Financial Assistance from the Department
of Social Welfare and Development.

Issued this __________ day of _______________ at

_____________________________________ Apayao.

MICHAEL L. LEOAG

Punong Barangay

Brgy. seal