Republic of the Philippines
Province of Pangasinan
Municipality of Infanta
BARANGAY BAYAMBANG
oOo
OFFICE OF THE PUNONG BARANGAY
BARANGAY CLEARANCE
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY JERICO J. MARCHA, 17 years old, single and a bonafide resident of
Barangay Bayambang is of good moral character and upbringing.
THIS IS TO CERTIFY FURTHER upon verification of the records filed in this office, the
subject person has never been convicted nor indicted of any crime involving moral turpitude.
This certification is issued upon the request of the said person for:
SCHOOL REQUIREMENTS
(Purpose)
Issued 9th day of June, 2014 at Bayambang, Infanta, Pangasinan.
________________________
Signature of Applicant
Prepared by:
BENJIE E. ANCHETA
Barangay Secretary
Attested by:
RAMON M. ABELLA
Punong Barangay
(Not Valid without Barangay Dry Seal)
O.R. NO.: No O.R. Available CTC NO.: N/A
DATE ISSUED:
PLACE ISSUED:
(Note: This clearance is valid only until 5 months upon issue)