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OFFICE OF THE PUNONG BARANGAY

THIS IS TO CERTIFY that ________________________________


(name of the child)

HON. JANICE Q. ORSAL


Brgy. Chairman _______ was born on _____________________________________
(sex) (Date)
KAGAWADS
at ____________________________________________ of parents
HON. IMELDA O. TOMBADO (Place)
HON. MELITON L. PICARDAL
HON. KIM IAN S. LOPEGA
HON. FELIX R. DERILO __________________________________and ___________________________________________
HON. RUBEN O. GERONIMO (Name of Mother) (Name of Father)
HON. RUEL O. GERONIMO
HON. NOEL M. MEJICA
of______________________________________________________________________________.
(Place)
MRS. NYMPHA P. ABEJUELA
BRGY. Treasurer

MRS. ROSIE M. ALEGRE


BRGY. Secretary
This Certification is issued upon request of the interested party for
the delayed registration of Live Birth of the above-named person.

Given this _______day of ___________________________2019,


at Barangay Aguinaldo, Arteche, Eastern Samar Philippine.

Certified:

HON. JANICE Q. ORSAL


Barangay Chairman

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