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( I-Iu"':uit': Ir.:#,3fl'' ,) : No Tto
( I-Iu"':uit': Ir.:#,3fl'' ,) : No Tto
August 7,2AZA
ln accordance with Republic Act No.9711 and other related resources , we RIGHT.MEDS
FI-IABMACY with business address at FANTUA VILLAGE, BRGY. ZONE III, K0R0NADAL CITY.
Hereby authorize MELENIO J. BASCO as the account holder of eLTO and shall be responsible far
all applications submitted through the eLTO system.
Ihereby undertake and warrant that the data and information submitted in connection with this
application as well as other submissions in the future including variations are true, correct and
reflect the total information available,
J. RABIA
{;i-iu"':uit':;ir.:#,3fl''*,}
and sworn to me this
Submitted
AU$ o TNzo
day of
at Koronadal GIt,
Notary Public