Amelia Dizon Vawc Cert.

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Republic of the Philippines

Province of Tarlac
Municipality of La Paz
BARANGAY MOTRICO
Office of the Punong Barangay

CERTIFICATION

TO WHOM IT MAY CONCERN

This is to certify that , years of age, Filipino


citizen, is a bonifide resident of Barangay Motrico La Paz Tarlac.

I therefore certifies that he/she has been separated/widowed since


and he/she is a solo parent custody of her children.

Name
1.
2.
3.

This certification is being issued this day of , 202 at the Office of the Punong
Barangay Motrico, La Paz Tarlac.

AMELIA Y. DIZON
Barangay VAWC

Hon. DOMINGO A. ALBERTO


Punong Barangay

Not valid without Barangay Seal

Republic of the Philippines


Province of Tarlac
Municipality of La Paz
BARANGAY MOTRICO
Office of the Punong Barangay

CERTIFICATION

TO WHOM IT MAY CONCERN

This is to certify that MR. JOHN MICHAEL P. YAQUITIN, of legal age, address at Barangay
Motrico La Paz Tarlac, is not included on the list of PUI/PUM nor Positive of COVID-19 pandemic.
Further certifies that MR. JOHN MICHAEL P. YAQUITIN, did not show any signs and
symptoms of COVID-19.

This certification is being issued this 30 th day of December, 2020 upon request of MR. JOHN
MICHAEL P. YAQUITIN. This may not be used for medico-legal purposes.

Hon. DOMINGO A. ALBERTO


Punong Barangay

Not valid without Barangay Seal

Republic of the Philippines


Province of Tarlac
Municipality of La Paz
BARANGAY MOTRICO
Office of the Punong Barangay

APPOINTMENT

January 21, 2021

To: AMELIA Y. DIZON


Brgy. Motrico La Paz, Tarlac

Sir/Madam:

Pursuant to the provisions of Section 389 of Republic Act No. 7160, otherwise known as the
Local Government Code of 1991, you are hereby appointed as BARANGAY VAWC (Violence Against
Women and Children) of Brgy. Motrico La Paz, Tarlac.

As such, you shall perform the duties and functions of the office and assume the power and
responsibilities thereto upon taking your Oath of Office.

This appointment is being issued this 21 st day of January, 2021 at Barangay Motrico La Paz,
Tarlac.
Conforme:
DOMINGO A. ALBERTO
Punong Barangay

Not valid without Barangay Seal


COMPLIANCE MONITORING FORM: REPUBLIC ACT 9344
As of
Region
Province/HUC
Municipality
Barangay

Total Republic ACT 9344 Cases Reported Total Cases Acted Up

Name of Minor: Type of Case Referred to Referred to PNP Referred to


No. Children-in Conflict with LSWPO Court
the Law (CICL)

Submitted by:
Noted by:
AMELIA Y. DIZON
ALBERTO A. DOMINGO
Signature Over Printed Name
Signature Over Printed Name
VAW Desk Officer
Punong Barangay
Republic of the Philippines
Province of Tarlac
Municipality of La Paz
BARANGAY MOTRICO

OFFICE OF THE SANGGUNIANG BARANGAY

CERTIFICATE OF INDIGENCY

TO WHOM IT MAY CONCERN

This is to certify that , of legal age,


( ) single ( ) married ( ) widow/er, a ( ) bonafide ( ) temporary resident of Barangay Motrico
La Paz Tarlac, and is the of .
That according to record kept in this office subject individual is one of the
INDIGENT MEMBER of this community.
This certification is issued upon request for whatever legal purposes it may serve.
Given this day of at Barangay Motrico La Paz Tarlac.

Purpose:

Hon. DOMINGO A. ALBERTO


Brgy. Captain
Brgy. Motrico La Paz Tarlac

Not valid without Barangay Seal

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