AUTHORIZATION

I, _FERMO JR. B. ASUFRA_ hereby authorize BISU or its authorize representative to deduct
certain amount representing the service charges out of the Six Hundred Pesos ( Php 600.00)
to be able to send to my address by reason:

✓ It will be costly for me to travel to BISU Balilihan to pick up the said amount;
It is impossible for me to travel BISU Balilihan since I am currently out of the province;
Others: _____________________________________________________________

Date: __MAY 20, 2021__

Active Contact Number: __0998-456-4302__

Complete Address: _POBLACION, CATIGBIAN, BOHOL_

____FERMO JR. B. ASUFRA____

Signature over printed name

__________________________________________________________________________________________

CERTIFICATION

This is to certify that I, _________FERMO JR. B. ASUFRA__________, ___BSIT – 3B___,

2nd Sem, S.Y. 2020-2021, Bohol Island State University ( BISU) Balilihan Campus, received
the amount of Six Hundred Pesos ( Php 600.00) as communication allowance for the months
March to April, 2021 and that I, shall utilize the said amount solely for the communication
access directly to the subjects/ programs that I am enrolled for the semester.

____FERMO JR. B. ASUFRA____

Signature over printed name