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Request Requester's Summary Acknowledgement

Payment

Details &

- Delivery

BIRTH Details

Reference Number : 0841-8002-8600-0101

Print two (2) copies of this page.

You will be asked for a copy of this page when paying for your requests in our designated banks. The other copy is your
personal copy.

This acknowledgement has also been sent to you through email.

Contact and Delivery Information

Requester's Name : MACALINO, JUSTINE CHESCA

Delivery Address : BLOCK 16 LOT 51 CAMANSI STREET, FIESTA COMMUNITIES

BARANGAY DAPDAP, MABALACAT CITY

PAMPANGA, PHILIPPINES 2010

Request Date: 01/18/2023

Total Amount Due: PHP 330.00

Request Summary

CERTIFICATE DOCUMENT EVENT

TYPE OWNER'S NAME DATE EVENT PLACE NUMBER OF COPIES AMOUNT

BIRTH MACALINO, 10/17/2009 QUEZON CITY, METRO 1 PHP

JUSTINE CHESCA MANILA, PHILIPPINES 330.00

IMPORTANT

Civil Registry documents can only be issued to:

1. The owner himself or through a duly authorized representative

2. His/her spouse, parent, direct descendants, guardian or institution legally-in-charge of him/her, if minor
3. The court or proper public official whenever absolutely necessary in administrative, judicial or other proceedings to determine the
identity of a person
4. In case of the person’s death, the nearest of kin

If you are the document owner and you are unable to receive the document, you may authorize a representative to do so
on your behalf. Your authorized representative will have to present the following to the courier:

1. Your signed authorization letter/Special Power of Attorney (SPA), stating the facts of the requested documents, number of copies
and purpose
2. Your valid ID (with photo and signature), including PhilID
3. The valid ID (with photo and signature) of your authorized representative, including PhilID

Note: The requester shall only be allowed to submit up to two (2) requests for non-related individuals.

PRINT PROCEED TO PAYMENT

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