_____________, 2020

Hon. _____________________
Governor & chairman PDRRMC
Province of ________

ATTN: ____________________
Department Head – APSEMO
PDRRMC

Dear Governor ____________,

Referred to the Provincial IATF on COVID-19, through the PDRRMC of ________, the
request of ___________________________, the proprietor of ___________________________,
engaged in the production and delivery of essential goods, with office address at
______________________________, to allow _____________________________, an
employee of the above stated company, to fulfill his work-related duties.

As such, I recommend that he should be allowed to pass the borders (vice versa) to
deliver _________________________________ in ______________________________.

Said company is allowed to operate under the Omnibus Guidelines on the implementation
of Community Quarantine issued by the Inter-Agency Task Force for the management of
emerging infectious diseases. Moreover, their employees are exempted from travel restriction
pursuant to the above cited rule and all other pertinent issuances relative to the containment of COVID-
19.

Attached herewith is the medical certificate of the abovementioned person for your
reference.

Truly yours,

___________________
Mayor

Vehicle Description: __________________________