Republic of the Philippines
Province of Leyte
Municipality of Carigara
BARANGAY JUGABAN
Office of the Punong Barangay
BARANGAY CLEARANCE
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY THAT Mrs. CAMILIA C. CAPALAR is a bonafide resident of Brgy.
Jugaban Carigara Leyte.
THIS FURTHER CERTIFIES that he/she is known to the undersigned to be a person of good
moral character whose reputation in the community is beyond reproach.
This certification issued upon the request of herein subject for the purpose of:
_____ a. New / Renewal of Business Permit for:
Kind of Business: ______________________________
Business Name: ______________________________
Business Address: ______________________________
Years in Business: ______________________________
_____ b. Police Clearance
_____ c. Enrollment ( School Requirement )
_____ d. Employment ( Local and Abroad )
_____ e. Electrical Connection / Installation ( LEYECO III )
_____ f. Water Connection ( MCWD )
_____ g. Building Permit
_____
h. Others ( Specify ) PERSONAL COLLECTION
Issued this 4th day of August at Brgy. Jugaban Carigara, Leyte.
HON. PEDRO ROYO
Punong Barangay
Clearance Fee: Php 20
DST Fee: Php 30
OR No. 6593510