Republic of the Philippines

Province of Iloilo
Municipality of Tigbauan
BARANGAY 8 POBLACION

AUTHORIZATION

This is to authorize ___________________________________________________________ ________________________________ _____

First Name Middle Name Surname Relationship to beneficiary Age
of Barangay 8 Poblacion, Tigbauan, Iloilo to claim/receive my financial assistance for Typhoon Odette
amounting to __________________________________________________________________ (Php___________) due to _____________________
_______________________________________________________.
State the reason for absence

Signature over Printed Name of Beneficiary/ Thumbmark Signature over Printed Name of Authorized Representative

Authorized representative identified and guaranteed to receive the grant by:

ELENA J. TITULAR
Punong Barangay

Republic of the Philippines

Province of Iloilo
Municipality of Tigbauan
BARANGAY 8 POBLACION

AUTHORIZATION

This is to authorize ___________________________________________________________ ________________________________ _____

First Name Middle Name Surname Relationship to beneficiary Age
of Barangay 8 Poblacion, Tigbauan, Iloilo to claim/receive my financial assistance for Typhoon Odette
amounting to __________________________________________________________________ (Php___________) due to _____________________
_______________________________________________________.
State the reason for absence

Signature over Printed Name of Beneficiary/ Thumbmark Signature over Printed Name of Authorized Representative

Authorized representative identified and guaranteed to receive the grant by:

ELENA J. TITULAR
Punong Barangay