Certification: Office of The Barangay Captain

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Republic of the Philippines

__________________________
Province of _________________
MUNICIPALITY OF _______________
___________________________

OFFICE OF THE BARANGAY CAPTAIN

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that _______________ and _______________________, both bona fide


residents of Barangay _______________, of legal ages, has been cohabiting as husband
and wife without the benefit of marriage for more than eight (8) years already.

This certification is issued to _______________ and __________________ for the


purpose of marriage and likewise issued for whatever legal purpose it may serve.

Issued this 2nd day of January 2021 at _________________________.

_________________________
Barangay Captain

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