FM-CSVlrd-07

COMPANY LETTERHEAD

(Date)

The Director General

Philippine Drug Enforcement Agency
Nat’l Gov’t Center, Brgy. Pinyahan
Diliman, Quezon City

Attention: The Director, Compliance Service

Subject: Letter of Authorization

Dear Sir,

As the (head/owner/GM/BM) of (company/ establishment), I hereby delegate my authority

to handle precursors and essential chemicals & its mixtures in favor of our company to
(name), (designation). As such, (he/she) is authorized to sign for and in behalf of the
company in matters/transactions pertaining to the above-mentioned preparations.
Likewise (he/she) will be responsible for its monitoring / safekeeping, recording, and
reporting to the Compliance Service, Philippine Drug Enforcement Agency.

In relation, enclosed herewith is the picture, specimen signature, joint

affidavit, NBI Clearance and TIN of (name of authorized signatory)

Very truly yours,

(Printed Name/ Signature and Designation of Owner/Head/GM/BM )

2” x 2” ID Picture 2” x 2” ID Picture
with signature with signature
(taken not later than 1 (taken not later than 1
month from date of month from date of
application) application)

Owner/Head/GM/BM Authorized Signatory

Rev_0_April 30, 2018