Certification: Office of The Tribal Chieftain

Republic of the Philippines
Province of _____________________
City of __________________
Barangay of _____________________
OFFICE OF THE TRIBAL CHIEFTAIN
CERTIFICATION
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that ________________________________________________

of ______________________________ belong to the _________________________________
Tribe of the Indigenous Cultural Communities.
His / her parents, ______________________________ and ___________________________

being both members of the _______________________Tribe.
This certification is issued for whatever legal purposes it may serve his/her
best.
____________________________________________
Printed name / Signature of Tribal Chieftain
SUBSCRIBED AND SWORN to before me this _____________________ day

of_________________, 20___ at _____________________________________affiant having
exhibited to me his / her Residence Certificate No. ___________________________
issued at_________________________________ on _________________________________.
_________________________________
(Officer Administration Oath)
Judge/Fiscal/Clerk of the Courts/
Mayor/Notary Public
REPUBLIC OF THE PHILIPPINES)
Province of _________________________) S.S
City of _____________________________
JOINT AFFIDAVIT
We _____________________________________ and ___________________________

All of legal ages, both resident of_____________________________________________
_______________________ after having been duly sworn in accordance with law, hereby depose
and say:
1. That we are personally know ______________________________________________ a

Full _________ half _________ one fourth blooded _________member of the
Cultural communities belonging to the _____________________ tribe (s) was born
on _______________________ at ________________________________________
2. That his/her father ____________________________________________________ is a

Full _________________ half _____________ one forth __________ not a member
of the Cultural minorities belonging to the ___________________________________ tribe
3. That his/her Mother ___________________________________________________ is a

Full ________________Half ____________one forth ___________ not a Member
of the Cultural minorities belonging to the ____________________ tribe.
4. That we execute this affidavit to establish the fact that the above-named
Person is a bonafide member of the National Cultural Minorities
IN WITNESS WHEREOF, we hereunto affix our signature this__________ day of

_____________________ at ________________________________________
______________________________ ___________________________
Affiant Affiant
Res. Cert. No. ___________________ Res. Cert. No.________________

Date if issue ____________________ Date of issue ________________
Place of issue____________________ Place of issue ________________
SUBSCRIBED AND SWORN to before me this ______________ day of

______________________ at ___________________________ Affiants exhibited their
Res. Cert. No. As shown under their respective signatures.
_____________________________
Officer Administrative Oath
Province of _____________________
City of __________________
Barangay of _____________________
OFFICE OF THE PUNONG BARANGAY
CERTIFICATION
TO WHOM IT MAY CONCERN:
This is to certify that __________________________________________ of

__________________________________________ is a member of the Indigenous
Peoples belonging to ________________________________ ethnic tribe. His / her
parents ______________________________ and _______________________________ being
members of the ________________________________ and __________________________
tribe, respectively.
____________________________
Punong Barangay
SUBSCRIBED AND SWORN to before me this _____________ day of

________________________, 20_____ at ________________________________. Affiant
having exhibited to me his / her Residence Certificate No. __________________
Issued at ______________ on ____________________ , 20_____.
______________________________
(Officer Administering Oath)

OFFICE OF THE PRESIDENT
NATIONAL COMMISSION ON INDIGENOUS PEOPLES
Region X
Lanao del Norte Provincial Office
Iligan City
COC FORM 1
CERTIFICATE OF CONFIRMATION
INFORMATION INDEX
PURPOSE: (check only one (1) box)

( ) 1. Scholarship ( ) 4. Travel Abroad
( ) 2. Local Employment ( ) 5. NAPOLCOM Requirement
( ) 3. Land Matter ( ) 6. Other Identification / Tribal
Membership
I. PERSONAL INFORMATION
Name: _____________________________ Sex: ______ Civil Status: ____________

Address: _____________________________________________________________
Place of Birth: ________________________________ Tribe: ___________________
Date of Birth: _________________________________________________________
If married, name of spouse: ___________________ Tribe: ___________________
II. EDUCATIONAL BACKGROUND
Highest Educational Attainment: __________________________________________

Degree Obtain: ________________________________________________________
III. PARENTAL BACKGROUND
FATHER MOTHER
Name: ______________________________ Name: ___________________________

Address: ____________________________ Address: _________________________
Tribe: ______________________________ Tribe: ___________________________
Grandfather: _________________________ Grandfather: ______________________
Tribe: ______________________________ Tribe: ___________________________
Grandmother: ________________________ Grandmother: _____________________
Tribe: ______________________________ Tribe: ___________________________
IV. If purpose of certification is land matter, fill up the following:
Homestead / Free Parent No.______________________________ Lot No. ____________

Date of Issuance ________________________________________Area No. ___________
Location _________________________________________________________________
I declare under the penalties of perjury that the answer given are true and correct to the
best of my knowledge and belief.
_________________________ ____________________________
Date Accomplished (Signature of Applicant)
Res. Cert. No. ________________
Issued at ____________________
Issued on ____________________

Certification: Office of The Tribal Chieftain

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Republic of the Philippines

OFFICE OF THE TRIBAL CHIEFTAIN

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that ________________________________________________

His / her parents, ______________________________ and ___________________________

SUBSCRIBED AND SWORN to before me this _____________________ day

Province of _________________________) S.S

We _____________________________________ and ___________________________

1. That we are personally know ______________________________________________ a

2. That his/her father ____________________________________________________ is a

3. That his/her Mother ___________________________________________________ is a

IN WITNESS WHEREOF, we hereunto affix our signature this__________ day of

Res. Cert. No. ___________________ Res. Cert. No.________________

SUBSCRIBED AND SWORN to before me this ______________ day of

OFFICE OF THE PUNONG BARANGAY

TO WHOM IT MAY CONCERN:

This is to certify that __________________________________________ of

SUBSCRIBED AND SWORN to before me this _____________ day of

Republic of the Philippines

PURPOSE: (check only one (1) box)

Name: _____________________________ Sex: ______ Civil Status: ____________

II. EDUCATIONAL BACKGROUND

Highest Educational Attainment: __________________________________________

III. PARENTAL BACKGROUND

Name: ______________________________ Name: ___________________________

IV. If purpose of certification is land matter, fill up the following:

Homestead / Free Parent No.______________________________ Lot No. ____________

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His / her parents, ____ and _

We ___________ and _

Res. Cert. No. ___ Res. Cert. No.

Name: _______________ Sex: Civil Status:

Name: ____ Name: _

Homestead / Free Parent No.__________________ Lot No.