ASA Philippines Foundation

Dapitan City

Zamboanga Del Norte, 7100

To whom it may concern:

I Alice Cabasag Dionsay, hereby authorize my husband to withdraw with the amount of
ONE THOUSAND ONE HUNDRED PESOS (₱1000. 00) on my behalf to my account in all
services relating to ASA Philippines Foundation located at Dapitan City Philippines.

I hereby authorize Janny Ruiz Dionsay to take over the custody in my account for this
medical reason, we are under Home Quarantine at the moment and hopefully be released on
February. Hoping for your kind consideration.

Enclosed are the copies of my identification card and my husbands which are required for
verification.

Thank you.

Sincerely,

_________________________________

ALICE CABASAG DIONSAY

Attached:
- Copy ID/Passport