ANNEX 10

REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF EDUCATION

Region : I
Division : Vigan City
School : Ilocos Sur National High School-SHS
ID Code : 300052

I, LLANES,JOBERT null BALOALOA qualified JDVP-TVL recipient with Voucher No. 302-MPJ-0009315
for SY 2019-2020 per D.O. No. 19 s, 2019, hereby authorize the following subject to the provision of
the said D.O.:

1. _Data Center College of the Philippines-Vigan City Branch____, __407616______ to collect

from the Department of Education the assessed value/cost of my education and training
provided by the cited institution; and
2. For the Department of Education to pay the cited institution the value of my voucher,
representing the validated value/cost of my education and training provided by the cited

LLANES,JOBERT
LLANES,JOBERT null BALOALOA
null BALOALOA
Signature over printed name

LRN 100456070030
Voucher No. 302-MPJ-0009315

Certified

_DAVE FONTEJON___
Signature over Printed Name
Class Adviser

Conforme: Approved:

_____________________________ ROMULO Q. QUITEVIS

Signature over Printed Name Signature over Printed Name
Parent/Guardian School Head