Philippine Standard Time
Barangay San Roque Rosario, Batangas, Philippines

Clearance Request Form

Please fill in all required fields to process your request

Personal Information

Please provide your complete personal details

First Name
Middle Name
Last Name
Suffix
Sex
Civil Status
Date of Birth
Purok

Clearance Purpose

Select the purpose for requesting this clearance

Purpose of Clearance

Select "Others" if your purpose is not listed above

Important Reminders

  • Please ensure all information provided is accurate and complete
  • You will receive a reference code after submission for tracking your request
  • Processing time may vary depending on the type of certificate
  • Bring a valid ID when claiming your certificate