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    Document Form

    Uploaded by

    Lubin Banto

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    © All Rights Reserved
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    Document Form

    Uploaded by

    Lubin Banto
    3 views2 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    3 views2 pages

    Document Form

    Uploaded by

    Lubin Banto

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Republic of the Philippines

    Province of Benguet
    Municipality of Sablan
    BARANGAY BANENGBENG
    Barangay Document Request Form: No.______

    Requestor's Information:
    1. Name: ___________________________________________________________________
    2. Address: _________________________________________________________________
    3. Contact Number:
    ___________________________________________________________
    4. Purpose of Request:
    _________________________________________________________

    Document(s) Requested:
    1. Type of Document: _________________________________________________________
    2. Specific Document:
    _________________________________________________________
    3. Number of Copies: _________________________________________________________

    Requirements:
    1. Valid ID (please attach photocopy)
    2. Proof of residency (please attach photocopy)
    3. Other relevant documents (please specify)

    Certification:

    I, _____________________________________________, hereby certify that the information


    provided is true and correct. I understand that the Barangay reserves the right to verify the
    authenticity of the documents and information provided.

    Signature: __________________________________________________________________
    Date: ______________________________________________________________________

    Barangay Official's Approval:

    1. Received by: ______________________________________________________________


    2. Verified by:
    _______________________________________________________________
    3. Approved by:
    ______________________________________________________________
    4. Date: ____________________________________________________________________
    Document Release:

    1. Date of Release:
    ____________________________________________________________
    2. Released by: ______________________________________________________________
    3. Number of Copies Released:
    __________________________________________________

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