September 14, 2023

AUTH O R I ZATI O N LETTE R

PHILIPPINE HEALTH INSURANCE CORPORATION

Fibertex Bldg. Corner Don Mariano Subdivision Ortigas Ext.,
Bgy. San Juan Cainta, Rizal

To whom it may concern,

This is to authorize EMPLOYEE NAME whose signature appears below to do and

perform for and in behalf of our company, COMPANY NAME the following transactions:

A. To inquire for computation of my unpaid Interest and/or Surcharges Incurred

for the Previous Period
B. To receive, sign, execute file, submit and deliver any and all documents
related thereto
C. To do all acts necessary to fully accomplish the above purposes
D. And, to transact and process any and all necessary documents with regards
to my Business.

Attached herewith is my valid ID for verification purposes.

We will appreciate very much your utmost consideration and approval.

Thank you.

OWNER’S NAME EMPLOYEE NAME

BUSINESS NAME Admin Staff
Proprietor/tress