June 28, 2021

Philippine Statistics Authority

Iznart Street, Front of Amigo Mall
Region VI – Iloilo City

AUTHORIZATION LETTER

Dear Ma’am/ Sir:

I hereby grant my ___________________, the authorization to process, pay, sign, receive and
claim my certificate of live birth from your office on my behalf. I will not be able to personally do this
due to _______________________________.

For the verification of this process, I have attached herewith a copy of my valid ID for
identification purposes. My _______________ will likewise show her proof of identification.

In case you have any further doubt or confusion in relation to my request, please feel free to
contact me anytime at ___________________.

Thank you for your kind consideration.

Sincerely,

_________________________________