Mun Form No.

1A

Republic of the Philippines

PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA

Office of the Municipal Civil Registrar

TO WHOM IT MAY CONCERN:

We certify that among others the following facts of Death appear in our register of Death
on Page 09 of Book No. 33.

LCR Registry Number : 2011-101__________________ _______

Date of Registration : February 8, 2011 _____ ____ ______

Name of Deceased : SANCHA G. ESPEJON ______ ______

Sex : FEMALE___________________________

Age : 68 YEARS OLD______________________

Civil status : WIDOW___________________________

Nationality : Filipino____________________________

Date of Death : February 7, 2011 _______________

Place of Death : GENERAL LUNA, SURIGAO DEL NORTE___

Cause of Death : CARCINOMA OF THE LUNG____________

This certification is issued to SAlVIO N. ESPEJON, upon her/his request.

ANNIE A. MANTILLA
Municipal Civil Registrar
Verified:

NERIE B. LIM
Clerk

Paid Under or No. 4470561

Dated: APRIL 14, 2019
At General Luna, Surigao del Norte

NOTE: This Certification is not valid if it has mark of erasure or alteration of any entry.
Mun Form No. 1A

Republic of the Philippines

PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA

Office of the Municipal Civil Registrar

TO WHOM IT MAY CONCERN:

We certify that among others the following facts of Death appear in our register of Death
on Page 46 of Book No. 32.

LCR Registry Number : 1994-18___________________________

Date of Registration : JANUARY 17, 1994___________________

Name of Deceased : EMELIO F. RAZON ___________________

Sex : Male__________________ ___________

Age : 52 years old_________________________

Civil status : Married____________________________

Nationality : Filipino_____________________________

Date of Death : JANUARY 16, 1994____________________

Place of Death : Consuelo, General Luna, SDN___________

Cause of Death : Car Accident_________________________

This certification is issued to JUANITA R. SULPAS, upon her/his request.

ANNIE A. MANTILLA
Municipal Civil Registrar
Verified:

NERIE B. LIM
Clerk

Paid Under or No. 4172144

Dated: September 20, 2018
At General Luna, Surigao del Norte

NOTE: This Certification is not valid if it has mark of erasure or alteration of any entry.
Mun Form No. 1A

Republic of the Philippines

PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA

Office of the Municipal Civil Registrar

TO WHOM IT MAY CONCERN:

We certify that among others the following facts of Death appear in our register of Death
on Page 26 of Book No. 46.

LCR Registry Number : 1984-45___________________________

Date of Registration : JULY 5, 1984________________________

Name of Deceased : ATILANO R. MINGLANA_______________

Sex : Male______________________________

Age : 59 years old________________________

Civil status : Married____________________________

Nationality : Filipino____________________________

Date of Death : JULY 4, 1984________________________

Place of Death : General Luna, Surigao del Norte________

Cause of Death : Tuberculosis________________________

This certification is issued to VICENTE R. MINGLANA upon her/his request.

ANNIE A. MANTILLA
Municipal Civil Registrar
Verified:

NERIE B. LIM
Clerk

Paid Under or No. 4462136

Dated: Sept. 3, 2018
At General Luna, Surigao del Norte

NOTE: This Certification is not valid if it has mark of erasure or alteration of any entry.
Mun Form No. 1A

Republic of the Philippines

PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA

Office of the Municipal Civil Registrar

TO WHOM IT MAY CONCERN:

We certify that among others the following facts of Death appear in our register of Death
on Page 102 of Book No. 05.

LCR Registry Number : 2005-128 _________________________

Date of Registration : AUGUST 18, 2005____________________

Name of Deceased : LEON ESPEJON _____________

Sex : Male_______________________________

Age : 61 years old_________________________

Civil status : Married____________________________

Nationality : Filipino_____________________________

Date of Death : AUGUST 17, 2005_________________ ___

Place of Death : General Luna, Surigao del Norte______ __

Cause of Death : Cardiac Arrest_________ _____________

This certification is issued to Salvio N. Espejon upon her/his request.

ANNIE A. MANTILLA
Municipal Civil Registrar
Verified:

NERIE B. LIM
Clerk

Paid Under or No. 4462159

Dated: Sept. 3, 2018
At General Luna, Surigao del Norte

NOTE: This Certification is not valid if it has mark of erasure or alteration of any entry.
Mun Form No. 1A

Republic of the Philippines

PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA

Office of the Municipal Civil Registrar

TO WHOM IT MAY CONCERN:

We certify that among others the following facts of Death appear in our register of Death
on Page 23 of Book No. 07.

LCR Registry Number : 2015-364___________________________

Date of Registration : April 13, 2015_______________________

Name of Deceased : CLARITA MANTILLA ALIPAYO___________

Sex : Female_____________________________

Age : 70 years old_________________________

Civil status : Married____________________________

Nationality : Filipino_____________________________

Date of Death : April 11, 2015_______________________

Place of Death : General Luna, Surigao del Norte________

Cause of Death : Tuberculosis________________________

This certification is issued to LUZ PLAZA upon her/his request.

ANNIE A. MANTILLA
Municipal Civil Registrar
Verified:

NERIE B. LIM
Clerk

Paid Under or No. 4462161

Dated: Sept. 3, 2018
At General Luna, Surigao del Norte

NOTE: This Certification is not valid if it has mark of erasure or alteration of any entry.