Professional Regulation Commission Manila Annex "8" cPDCOUNCILOFIFOR DECLARATION | Aumsuond, PMEEE KEE Tot i ye, wih across ‘and applicant for Contruing Professional Development cred unt hereby declare and say that 1 | am a registerediicensed Nuesé ___ with Professional ldentieston Card No. DESITSY —Vecoed on 03/7724 2 During the State of Pubic Heath Emergency brought about by the Corona Vins Disesse "2019 (COVIO-18), | was assigned / rendered my services as Nase ‘lace Ab DUET to etd mnt FE pee PSLENT. 7 4. As proof of the saxd servces, attached hereto isthe Certiicaion in connection therewith ‘tom the insttutonagencyrentty andlor pictures during the actual 15. hereby atest that all information stated herein ae comect and complete, and that the docimentis submitted herewath are te, valid and genuine | am aware that Spptcaton oF the wihdrawal of CPO cred uns Wafeady gen. 8 wl = appropriate adminsiraive or erinnal charges. This 67d day of NUMMARY 2022 at__Abwig LEYTE Ps fr fie filing ese 7 nearenenn Blonatur over printed name “Appeal may provide adduonaliformaton’documents shad elshe wishes o do so Republe of the Dhvlippines | O P|