Republic of the Philippines)

Done: In the City of Baguio) s.s.

AFFIDAVIT OF AUTHORIZATION
I, JOSE D. ADNOL, legal age, married, Filipino citizen and with residence
and postal address at Ba-ayan Proper, Ba-ayan, Tublay, Benguet after having
been duly sworn to in accordance with law hereby depose and state that:

1. I am a member of the Sanguniang Bayan of the Municipality of

Tublay, Province of Benguet being a Municipal Councilor and have
finished my three-terms limit;

2. I am applying for Terminal Leave Benefits and among the

requirements is authorization in affidavit form;

3. In compliance therewith, I hereby authorized the Local Government

Unit of Tublay to deduct all my financial obligations;

4. I freely and voluntarily executing this authorization without coercing

or influencing me;

5. I am executing this affidavit to attest to the veracity and truthfulness

of the foregoing statements and for all legal intents and purposes it
may serve.

IN WITNESS HEREOF, I have hereunto affixed my signature this 1 st day

of July, 2019 at Baguio City, Philippines.

JOSE D. ADNOL
Affiant
Voter’s ID No. 1114-0025A-K1551JDA10000

SUBSCRIBED AND SWORN to before me this 1st day of July, 2019 at

Baguio City, Philippines. Affiant personally appeared before me and to be the
same person who executed this instrument and freely and willingly.

MODESTO T. ANDONG
Notary Public
Commission No. 39-NC-18-R/Until: Dec. 31, 2019
PTR No. 3954050/1-3-2019/Baguio City
IBP No. 02793/1-3-2019
Roll No. 31289/5-15-81/Manila
Doc. No. 53; MCLE COMPLIANCE No. VI-0000192/June 14, 2016
Page No. 11; BIR TIN No. 121-017-652
Book No. 37; No. 19, 2nd Floor Old Market Bldg.,
Series of 2019. Magsaysay Ave., Baguio City, Philippines