Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                

Certification Delayed Registration

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic of the Philippines

Province of Pangasinan
Municipality of Infanta
Barangay Bayambang
oOo

OFFICE OF THE PUNONG BARANGAY

CERTIFICATION OF DELAYED REGISTRATION

To whom it may concern:

This is to certify that the spouses LUZVIMINDA MANLANGIT MARFIL, 23 years old and
ANTONIO MERCED MORTIL JR., 41 years old, both residents of Barangay Bayambang and the
two lives as husband and wife outside of marriage.

This is to further certify that the aforementioned names have a daughter named
ANTONIA MARFIL MORTIL, who was allegedly been born on APRIL 18, 2013 at Western
Pangasinan District Hospital, Alaminos City, Pangasinan. And up to this date, the said child has
not been registered to the Civil Registrar’s Office.

This certification is being issued upon the request of Mr. Antonio M. Mortil Jr. for the
late registration of birth of his baby.

Issued this 26th day of December, 2013 at Bayambang, Infanta, Pangasinan.

Attested by:
RAMON M. ABELLA
Punong Barangay
(Note: Not valid without Barangay Dry Seal)

Paid Under:
O.R. No.: 2456543
Date: 12-26-13
At BTO-Infanta, Pang.

You might also like