Republic of the Philippines

Department of Social Welfare and Development

Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. MICHAEL A. ELESERIO DOMINADOR P. DAVID

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

____________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. MICHAEL A. ELESERIO DOMINADOR P. DAVID

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JESSIE G. SUCGANG PASCUAL P. TUPAS JR.

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JESSIE G. SUCGANG PASCUAL P. TUPAS JR.

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. AMILLA D. DELA VEGA LYDIA B. BALBINO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. AMILLA D. DELA VEGA LYDIA B. BALBINO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. VIVIAN V. DIONISIO JOSEPH B. PARCE

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

__________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. VIVIAN V. DIONISIO JOSEPH B. PARCE

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JOHN B. DELA CRUZ EUFEMIO S. SILVERIO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JOHN B. DELA CRUZ EUFEMIO S. SILVERIO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. ERLY R. BULANAG NELY R. DELA CRUZ

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

____________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. ERLY R. BULANAG NELY R. DELA CRUZ

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JINNER P. MALONES HELEN O. ROSALES

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. JINNER P. MALONES HELEN O. ROSALES

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RUDSON V. BERICO DANA P. LAUZ

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

__________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RUDSON V. BERICO DANA P. LAUZ

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

__________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RIZAL G. RODRIGUEZ, JR. NELSON D. RAVAL

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

__________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RIZAL G. RODRIGUEZ, JR. NELSON D. RAVAL

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. NELSON F. URETA MAXIMO S. SALAVANTE

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. NELSON F. URETA MAXIMO S. SALAVANTE

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. REGIE T. NEPOMUCENO VIOLA J. BOLIVAR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. REGIE T. NEPOMUCENO VIOLA J. BOLIVAR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines

Department of Social Welfare and Development

Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. MIRIXY C. VICENTE TEODORO F. PEÑAFLOR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. MIRIXY C. VICENTE TEODORO F. PEÑAFLOR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO
 Republic of the Philippines
Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

__________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. ROSAURO B. AMBROCIO ANTONIO I DAMIAN

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. ROSAURO B. AMBROCIO ANTONIO I DAMIAN

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

_______________________________________________________________________________________

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City
 AUTHORIZATION

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. GENE P. SUGAPONG THELMA S. GASPAR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

___________________________________________________________ to claim/receive my Social Pension Stipend for _______ semester of 2023

Address_

amounting to Php 3,000.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. GENE P. SUGAPONG THELMA S. GASPAR

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

______________________________________________________________________________________

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City
 AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. EUGENE B. PENALBA SOFRONIO A. MATIAS

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. EUGENE B. PENALBA SOFRONIO A. MATIAS

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City
 AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RUBY P. INSON BENITO I. SABINO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. RUBY P. INSON BENITO I. SABINO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________
This is to authorize ______________________________________________________________________,__________________________________, ________ of
First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. OSCAR D. PATRON NELIA A. PAULO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. OSCAR D. PATRON NELIA A. PAULO

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________
This is to authorize ______________________________________________________________________,__________________________________, ________ of
First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. OSCAR O. ALMANON NANCY M. VILLARUEL

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. OSCAR O. ALMANON NANCY M. VILLARUEL

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
 Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. STEPHEN P. BOLIVAR ERNESTO J. FLORES

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. STEPHEN P. BOLIVAR ERNESTO J. FLORES

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________
This is to authorize ______________________________________________________________________,__________________________________, ________ of
First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON. ROLLY B. SUCGANG NANCY J. SUCGANG

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO

Republic of the Philippines

Department of Social Welfare and Development
Field Office VI
M.H. Del Pilar St., Molo, Iloilo City

AUTHORIZATION
Date: _______________________

This is to authorize ______________________________________________________________________,__________________________________, ________ of

First Name, Middle Name, Surname Relationship to beneficiary Age

_________________________________________________ to claim/receive my Social Pension Stipend for _______ quarter of 2022 amounting
Address_

to Php 1,500.00 due to _____________________________________________.

State the reason for absence

__________________________________ _________ ___________________________________________________________

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

CRYZEL P. VEDASTO RONEL A. DALIDA

Signature over Printed Name of C/MSWDO Signature over Printed Name of OSCA Head

Authorized representative identified and guaranteed to receive the grant by:

HON._ROLLY B. SUCGANG NANCY J. SUCGANG

Signature over Printed Name of Brgy. Captain Signature over Printed Name of Brgy. President, SCO