CERTIFICATION

This is to certify that I, _________________________________(name of student),

______________________ (course/year/section), enrolled for the 1st Semester AY 2020-2021
at Bohol Island State University (BISU) Main campus, received the amount of Six Hundred
Pesos (Php600.00) as communication allowance for the months of January to February,
2021. That I, shall utilize the said amount solely for the communication purposes directly related
to the subjects/programs that I am enrolled for the semester.

________________________
Signature over printed name
Contact #: ________________

Date:

AUTHORIZATION

I, _________________________________(name of student), _______________

(course/year/section), 1st Semester AY 2020-2021, a resident of
_________________________________ (address).

I hereby authorize my _________________(relationship),

_______________________(name of the person authorized), to claim my load allowances from
BISU Main Campus amounting to Six Hundred Pesos (Php 600.00) for the reason of:
o It will be very costly for me to travel to Tagbilaran City to pick up the said amount;
o It is impossible for me to travel to BISU since I am currently out of the province;
o Others (pls specify: ___________________________________________

Signature over printed name of Signature over printed name of

Student authorized person

ID# presented: ID# presented:

Issued by: Issued by:

Contact #: Contact #: