Purok Clearance

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Republic of the Philippines

Province of Davao De Oro


Municipality of Monkayo
Barangay Salvacion

PUROK- _____

OFFICE OF THE PUROK CHAIRPERSON


=o0o=

PUROK CLEARANCE

TO WHOM IT MAY CONCERN;

THIS IS TO CERTIFY that __________________________________, of legal


age, married/single and a bona fide member of Purok - _____, ______________, Salvacion,
Monkayo, Davao De Oro, is known to me personally to be a person of good moral character and
not a member of any subsersive organization and a compliance of R.A. 9003.

FURTHER CERTIFY that they have cleared for all Purok obligations.

THIS CLEARANCE is being issued upon the request of the above-named


person for whatever legal purposes this may serve him/her best.

Issued this _____ day of _____________, 2021, at the office of the Purok
Chairperson, Salvacion, Monkayo, Davao De Oro.

_________________________ _________________________
Purok Treasurer Purok Secretary

_______________________________
Purok Chairperson

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