Professional Documents
Culture Documents
Province of Pangasinan
Municipality of Infanta
BARANGAY BAYAMBANG
oOo
I further certify that the holder/bearer was informed of his/her rights, including the
duties and responsibilitiesaccorded by RA 11261 through the Oath of Undertaking he/she has
signed and executed in the presence of our Barangay Official.
This certification is valid only ______ ( one (1) year from the issuance)
DANTE B, ANCHETA
Punong Barangay
_______________
Date
Witnessed by:
______________________________
Barangay Official/Designation/Position
RA 11261 Form 1
(Note: Not Valid without Barangay Dry Seal)