July 3.
2018
Address
Philippines 6041
The Personnel/In-Charge
Philippine Statistics Authority
Region VII-Cebu
Ground Floor Gaisano Capital, Colon St., Cebu City
Ma’am/Sir:
I, the undersigned, hereby authorize Miss xxxxxxxx to act on my behalf in all possible manners in the process of
requesting and/or claiming my PSA-Birth Certificate. This authorization is issued due to my failing health,
specifically bodily-issues on endurance for long travel and queuing.
Further, this letter grants her all the possible rights and privileges in line thereof.
Respectfully yours,
July 3. 2018
Cantu-od, Balamban, Cebu
Philippines 6041
The Personnel/In-Charge
Philippine Statistics Authority
Region VII-Cebu
Ground Floor Gaisano Capital, Colon St., Cebu City
Ma’am/Sir:
I, the undersigned, hereby authorize Miss Jenelin P. Alam to act on my behalf in all possible manners in the process of
requesting and/or claiming for my husband’s (Sotero Inot Dumdum) PSA-Death Certificate. This authorization is
issued due to my failing health, specifically bodily-issues on endurance for long travel and queuing.
Further, this letter grants her all the possible rights and privileges in line thereof.
Respectfully yours,
NATIVIDAD SIEMBRA DUMDUM