AUTHORIZATION LETTER

Date

VETERAN MEMORIAL MEDICAL CENTER

North Avenue, Diliman,
Quezon City Philippines

Dear Sir/Ma’am:

This is to authorize _________________to process my reimbursement and fill the necessary forms and sign
the same on my behalf, including follow up of my reimbursement status until such time that my
reimbursement shall be completed.

I have attached herein a copy of my Driver License No. _________ with signature for your reference.

Should you need additional information on this, please feel free to reach me _________________.

Thank you for your kind consideration.

Very truly yours,

_____________________________