SC Authorization Letter

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_____________________

Date

AUTHORIZATION LETTER

I, __________________________________________, recipient of Social Pension stipend, of legal


age,
(Name of Social Pensioner)

presently under the custody of my child/relative, ________________________________________,


at
(Name of Custodian)

______________________________________________, with contact number


__________________
(Complete Address) (Contact Number)

authorizes my ___________________________, __________________________________________,


(Relationship to Beneficiary) (Name of Authorized Representative)

who is presently residing at __________________________________________________, to claim


my
(Complete Address of Authorized Representative)

stipend in the amount of:


- 1st Semester CY 2023 ______________________ ₱ 3, 000.00
- 1st Semester CY 2023 ______________________ ₱ 3, 000.00

due to reason stated below:


- Bedridden₱ 3, 000.00
- Sick₱ 3, 000.00
- With Physical Ability₱ 3, 000.00
- Lockdown in other areas₱ 3, 000.00
Please specify the area ₱ _______________________

That I am fully aware that he/she will affix his/her signature in the payroll for and in my behalf.

Thank you.

______________________________________
(Signature over printed name of Beneficiary)

Conformed by:

________________________________________________
Signature over printed name of Authorized Representative

Attested by:

_______________________________________________
Signature over printed name of SC Brgy. Chapter President

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