Brgy. Certificate

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Republic of the Philippines

City of Manila
Barangay ____________

August 21, 2019

Certification

This is to certify that _(Petitioner/s)_ married/single and of legal age is a


bonafide resident of this barangay. Based on our records and as a
matter of public knowledge, she/they has/have been taking care of a
child named _________________ since _(month/date/ year)________.

This further certifies that the petitioner is among the residents who are
indigent and eligible to be exempted from payment of fees in relation to
the filing of Petition for Administrative Adoption with Application for
Rectification of Simulated Birth Record, pursuant to RA 11222, (as
applicable).

Issued this ____________, at City of Manila, Philippines.

_________________
Punong Barangay

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