PROOF OF AUTHORITY1

I, ____________________________________, of legal age, Filipino, with address at

________________________________________________________ hereby state:

1. I am the duly authorized representative of the hereunder beneficiary of the

Unconditional Cash Transfer Listahanan Identified Poor (LIP)
Social Pension (SocPen) of the Department of Social Welfare and
Development (DSWD):

__________________________________________________
Full Name of the Beneficiary (Including Middle Name)

2. Said beneficiary died on ________ day of ___________________ at

__________________________________________________.
(Place of Death)

____________________________________________________
Signature over Full Name of Claimant/Date

DOCUMENTS PRESENTED:

Valid ID (preferably government issued IDs) of Representative

Barangay Clearance

Death Certificate of Beneficiary

Others. Pls. Specify _________________________________

Validated and Certified by:

_______________________ _______________________
Barangay Captain MSWDO

1 This is an alternative document to Special Power of Attorney (SPA) executed by all heirs of the deceased beneficiary and issued for
purposes of claiming UCT grants ONLY.