AUTHORIZATION

This is to authorize in my behalf, ____________________________, _____________________

First Name, Middle Name, Surname Relationship to the Beneficiary

______ of ______________________________ to claim / receive my UCT Cash Card from

Age Address

Land bank of the Philippines due to _______________________________________________.

State the reasons for the absence

_________________________________ _________________________________
Signature Over Printed Name Signature Over Printed Name
of Beneficiary of Authorized Representative

_________________________________
Signature Over Printed Name
of Regional Director

*Relationship to the TRCT Project beneficiary may up to 2nd degree of consanguinity.

AUTHORIZATION

This is to authorize in my behalf, ____________________________, _____________________

First Name, Middle Name, Surname Relationship to the Beneficiary

______ of ______________________________ to claim / receive my UCT Cash Card from

Age Address

Land bank of the Philippines due to _______________________________________________.

State the reasons for the absence

_________________________________ _________________________________
Signature Over Printed Name Signature Over Printed Name
of Beneficiary of Authorized Representative

_________________________________
Signature Over Printed Name
of Regional Director

*Relationship to the TRCT Project beneficiary may up to 2nd degree of consanguinity.