Republic of the Philippines
Province of Bulacan
Municipality of San Ildefonso
Barangay Malipampang
RSBSA BARANGAY CERTIFICATE
This is to certify that __________, _____________, _____________, _______,
(Surname) (First Name) (Middle Name) (Ext. Name)
born on ________, residing at _________________________________________
(mm-dd-yyyy) (Complete Address – Purok, Barangay, City/Municipality, Province)
_______________, is tilling the following crop(s): __________________________
as _________________, at ____________________________________________
(tenant/lesse/specify) (Farm Location – Barangay, City/Municipality, Province)
owned by __________, _____________, _____________, _______,
(Surname) (First Name) (Middle Name) (Ext. Name)
with size ________ hectares since _____ / ______ /______.
(Month) (Day) (Year)
This certification is being issued by the Barangay solely for the purpose of the
farmers and fisherfolks registration to the Registry System Sectors in Agriculture
(RSBA) of the Department of Agriculture and may not be used for other purposes
not mentioned above.
__________________________ __________________________
RSBA Enrollee Committee on Agriculture
__________________________
Barangay Chairman
Area is Validated and Verified by:
___________________________ ____________________________________
Agricultural Extension Worker (AEW) Agricultural Program Coordinating Officer (APCO)