LEONCIO GENERAL HOSPITAL

Brgy. Pangobilian, Brookes Point, Palawan

June 24, 2022

The Director-General
Food and Drug Administration
Civic Drive, Filinvest City
Alabang, Muntinlupa City

Dear Director-General:

I, NARCISO B. LEONCIO, MD, Medical Director and the owner of LEONCIO GENERAL
HOSPITAL with business address at Barangay Pangobilian, Brooke’s Point, Palawan would like to
express my intent to apply for a RRD Portal user account to avail the RRD online authorization services
for the issuance of License to Operate LTO, Certificate of Facility Registration CFR, Clearance for
Customs Release CFCR, Certificate of Safety Evaluation CSE). I shall be responsible for all the
applications submitted through the RRD Portal System.

I hereby declare and undertake that all 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.

NARCISO B. LEONCIO, MD
(Owner of the Facility / Corporation)

SUBSCRIBED AND SWORN to before me, this ____ day of ____________ 20___ at
______________________________________.

__________________________
Notary Public

Doc No. __________

Page No. __________
Book No. __________
Series No. __________
 LEONCIO GENERAL HOSPITAL
Brgy. Pangobilian, Brookes Point, Palawan

June 24, 2022

The Director General

Food and Drug Administration
Civic Drive, Filinvest City
Alabang, Muntinlupa City

Dear Director General:

We, ______LEONCIO GENERAL HOSPITAL________ with business address at

Barangay Pangobilian Brooke’s Point, Palawan_______ hereby authorize Mr./Ms.
_____EVELYN G. PRESTO____ as the registered user/account holder of RRD online authorization
services for the issuance of License to Operate LTO, Certificate of Facility Registration CFR, Clearance
for Customs Release CFCR, Certificate of Safety Evaluation CSE) and shall be responsible for all the
applications submitted through the RRD Portal System.

We hereby declare and undertake that all 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.

__NARCISO B. LEONCIO, MD_____

(Owner / Legal Person of the Company)

SUBSCRIBED AND SWORN to before me, this ____ day of ____________ 20___ at
______________________________________.

__________________________
Notary Public

Doc No. __________

Page No. __________
Book No. __________
Series No. __________