Introduction
This certificate of indigency template is a general drafting reference for barangays, LGUs, or authorized local offices that issue certificates for residents who request proof of indigency for a specific purpose.
Issuance of this type of certificate depends on applicable local policies, eligibility rules, verification procedures, and the authority of the issuing office. This template should be reviewed and adapted before use by authorized personnel.
When to Use This Resource
Use this resource when preparing a draft certificate for a resident who needs documentation for purposes such as:
- Medical assistance
- Educational assistance
- Social welfare assistance
- Burial assistance
- Legal aid referral
- Government program application
- Other public assistance requests where a certificate is required
Template or Guide Body
Republic of the Philippines
Province of [Province]
City/Municipality of [City/Municipality]
Barangay [Barangay Name]
OFFICE OF THE PUNONG BARANGAY
CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:
This is to certify that [Full Name of Resident], [Age] years old, [civil status, if required], and a resident of [Complete Address / Purok / Sitio / Barangay], [City/Municipality], [Province], is known to this office.
Based on the records, interview, verification, and/or information available to this office, the above-named resident is considered [indigent / low-income / financially unable, according to the office's applicable wording and policy] and has requested this certification for the purpose of [state specific purpose].
This certification is issued upon the request of the above-named resident for whatever lawful purpose it may serve, subject to the rules, policies, and verification requirements of the receiving office or agency.
Issued this [day] day of [month], [year] at Barangay [Barangay Name], [City/Municipality], [Province].
[Name of Punong Barangay / Authorized Signatory]
Punong Barangay / Authorized Signatory
[Official Seal]
Prepared / Verified by:
[Name]
[Position / Designation]Notes for Customization
- Confirm who is authorized to issue and sign the certificate.
- Use the official barangay or LGU format if one already exists.
- Verify the resident's identity, address, and basis for certification according to local procedure.
- State the specific purpose clearly, such as medical assistance or educational assistance.
- Avoid adding sensitive details that are not required for the stated purpose.
- Confirm whether supporting documents, interviews, household assessment, or records checking are required.
- Use the official seal only according to authorized office practice.
Disclaimer
This template is for general reference and drafting assistance only. It does not guarantee eligibility, legal sufficiency, official approval, or acceptance by any receiving office or agency.
Certificates of indigency should be issued only by authorized offices and personnel following applicable local policies, verification procedures, records rules, and approval requirements.
Related Resources
- Barangay Resolution Template
- LGU Request Letter Template