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Barangay Clearance

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Republic of the Philippines PROVINCE OF QUIRINO Municipality of Maddela BARANGAY DIPINTIN oOo

OFFICE OF THE BARANGAY CAPTAIN

BARANGAY CLEARANCE
TO WHOM IT MAY CONCERN: THIS IS TO CERTIFY that ______________________________ of legal age, single/married and a bonafide resident of Barangay Dipintin, Maddela, Quirino. To my knowledge and belief she/he is of good moral character and law abiding citizen. Record of this office show that she/he has not been accused of any crime nor p[ending case. THIS CLEARANCE is issued upon the request of the above named person for whatever legal purposes it may serve. Issued this ________ day of ____________________, 2013 at Barangay Dipintin, Maddela, Quirino.

RANDY G. MATEO Barangay Captain

Paid under O.R. No. __________________ Issued on: __________________________ Issued at: Dipintin, Maddela, Quirino CTC No. _________________________ Issued on: ________________________ Issued at: Dipintin, Maddela, Quirino

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