December 19, 2019

Dr. ALEXANDER R. MADRIGAL, CESO III

Regional Director
DOST- CALABARZON
Jamboree Road, Timugan, Los Banos, Laguna

Dear Mr. Madrigal,

I, John Rudolf M. Loria, a past scholar of Department of Science and Technology under the
Junior Level Science Scholarship Program (RA 10162), is humbly asking for a temporary clearance and
certification for the purpose of having a family vacation. My family will be having a vacation next year
that is from January 13 to January 17 of 2020 going to Taiwan. I am currently working in Taysan National
High School Senior High School Department. I pledge that I will be continuing my return of service in
spite of our scheduled family vacation. I have no plans of working abroad and of breaching the return of
service stated on the scholarship’s terms and conditions. Hoping for your kindness and consideration.

If you have any request for additional requirements or information, kindly call/ message me on
the number stated below. Thank you!

Respectfully yours,

John Rudolf M. Loria

DOST Scholar
RA 10162
Cellphone No. : 09230813153