Date : May 29, 2023

To : The Branch Head

Landbank of the Philippines
_____DARAGA_____ Branch

Subject : Authority to Debit/Credit Account

TF Account
Please debit ________________________ No.3872-1012-75
______________________________________
(Account Number/Account Name)

the amount of PESOS _______________________________________________________

One Hundred Thirty-Three Thousand Four Hundred

Fifteen Pesos & 38/100

_____________________________________________________ 133,415.38
(P _________________)

GF Account No. 3872-1005-97

and credit ________________________________________________________________
(Account Number/Account Name)

Representing:
__________________________________________________________________

This is to authorize you to debit my/our account for the corresponding service charge

For Joint Account: I/We declare under penalty perjury that my/our co-depositor/s is/are
still living.

CORAZON L. MARILLA CARLOS IRWIN G. BALDO, JR.

(Name and Signature of Authorized Signatory) (Name and Signature of Authorized Signatory)

Verified by: Checked by: Approved by: Sight Verified by:

MACHINE VALIDATION