Mary Ann Fermis Garcia
0937469433 maryanng955@gmail.com
January 27 1991
Purok masagana
Ransohan Lucena city Quezon
Ana joyce Gfermid Garcia
09564937939
________________________________________
Representa ve’s Signature Over Printed Name
Posi on/Rela onship to Applicant
________________________________
Company/Business En ty
________________________________
Date
AUTHORIZATION
Re: Service Application No. ______________________
Date ____________________
Manila Electric Company
Lucena Business Center
Doña Aurora Blvd.
Gulang-gulang, Lucena City
Gentlemen:
In connection with my application for electric service at SUAY ELECTRICAL , I hereby authorize
to execute or sign all or any of the following documents on my behalf:
(PLEASE AFFIX YOUR SIGNATURE BESIDE THE APPLICABLE DOCUMENT/S)
√ _________________________ Contract of Electric Service (for ___ kW applied load)
_________________________ Undertaking
_________________________ Grant of Right of Way
√ _________________________ Waiver
√ _________________________ Others; Please specify ___________
For this purpose, I likewise authorize him/her to transact in your office, submit any and all required papers or docu-
ments and pay all necessary fees and deposits in connection with the application.
By executing this authorization, I hereby affirm and agree to be bound by the representations and actions of my rep-
resentative and to comply with the terms and conditions for the provision of electric service at the address aforemen-
tioned.
For your reference, attached are photocopies of my ID and that of my representative.
Applicant / Owner
Signature Over Printed Name
Certified by MERALCO(CBM) / Representative
Signature Over Printed Name
Garcia
_____________________________
Signature Over Printed Name