REPUBLIC OF THE PHILIPPINES
MUNICIPALITY OF TUMAUINI
BARANGAY SAN PEDRO
Office of the Barangay Captain
BARANGAY CLEARANCE
This is to certify that the person whose name, picture and signature appear herein has
requested a CLEARANCE from this office.
Name: ___________________________________ Gender: ____________________________
Address: SAN PEDRO TUMAUINI, ISABELA Date of Birth: _______________________
Civil Status: _______________________________ Place of Birth: _______________________
Purpose: FOR LEGAL PURPOSES ONLY
2x2 Recent ID Picture Signature
Left Thumb Mark Right Thumb Mark
This is to certify further that he is known to me as person of good moral character and is
a law abiding citizen. He has no pending case nor derogatory record in our office.
Issued this _______________ day of___________________________ , ________________ at the
Office of the Barangay Captain, Barangay San Pedro Tumauini, Isabela.
Place Dry Seal Here
MARICON M. PADILLO
Barangay Captain
Note: Not valid without official seal. This Barangay Clearance is only valid (6) six months from the date of issue.
fer-jtagacay