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MRS.

ABCD
___________________
___________________

June 25, 2021

THE PHILIPPINE STATISTICS AUTHORITY


PSA Complex, East Avenue
Diliman, Quezon City

To whom it may concern:

I, Mrs. ABCD, do hereby authorize ATTY. XYZ to secure and claim the death certificate of my
husband, EFGH, as I am unable to do so due to current health situations in the Philippines, and
Atty. XYZ being the one in charge for settling the estate of my grandparent-in-law, HIJK.

Attach herewith is a copy of my Senior Citizen identification card as proof of my consent on this
matter. The bearer will also show photocopy of her UMID for verification purposes.

Thank you very much and looking forward for your consideration.

Sincerely yours,

MRS. ABCD

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