Republic of the Philippines

Province of Cavite
City of Tagaytay

AUTHORIZATION

The bearer is _____________________________________ and residing at Barangay

(Name of Authorized Person)
Neogan, Tagaytay City. He/She is my _________________ and I am him/her to receive my Benepisyo
ng Tagaytay (BNT) benefit for the month of _______________ due to
____________________________.
(Reason)

__________________________
Printed Name of Senior Citizen

_____________________________
Signature of Authorized Represenatative

Republic of the Philippines

Province of Cavite
City of Tagaytay

AUTHORIZATION

The bearer is _____________________________________ and residing at Barangay

(Name of Authorized Person)
Neogan, Tagaytay City. He/She is my _________________ and I am him/her to receive my Benepisyo
ng Tagaytay (BNT) benefit for the month of _______________ due to
____________________________.
(Reason)

__________________________
Printed Name of Senior Citizen

_____________________________
Signature of Authorized Represenatative