Temps and Staffers, Inc.

2/F Servicio Filipino Bldg., 105 West Avenue Q.C.

AUTHORIZATION LETTER
(INACTIVE)
Please accomplish this form in one transaction per claim only.

Employee Name

Place of Assignment

Date of request

Claims (Please specify) Last Payroll

I having been separated from Temps and Staffers, Inc. hereby authorize Temps and
Staffers, Inc. to deposit the last payables due to me to:

Account Name: ______

Account Number:
Bank Name/Branch:

I acknowledge that Temps and Staffers, Inc. is not responsible or liable for damage of
any kind sustained during this transaction and I have executed this request voluntarily.

Signed this th day of 201_ in Philippines.

Employee's Signature Over Printed Name

Contact no.: _______

 Temps and Staffers, Inc.
2/F Servicio Filipino Bldg., 105 West Avenue Q.C.

AUTHORIZATION LETTER
(INACTIVE)
Please accomplish this form in one transaction per claim only.

Employee Name

Place of Assignment

Date of request

Claims (Please specify) 13th Month Pay

I having been separated from Temps and Staffers, Inc. hereby authorize Temps and
Staffers, Inc. to deposit the last payables due to me to:

Account Name: ______

Account Number:
Bank Name/Branch:

I acknowledge that Temps and Staffers, Inc. is not responsible or liable for damage of
any kind sustained during this transaction and I have executed this request voluntarily.

Signed this th day of 201_ in Philippines.

Employee's Signature Over Printed Name

Contact no.: ______