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Date: December 18, 2017

Bais City, Negros Oriental

AUTHORIZATION LETTER

TO WHOM IT MAY CONCERN:

This is to AUTHORIZE __________________________________ of Brgy. Cambagahan, Bais


City, to transact with any pharmacy, medical/health establishments, or any and all other stores
and/or commercial establishments, to purchase and/or avail in my behalf the necessary
medicines, goods, supplies, merchandise, items, and services using my Senior Citizen ID card for
the purpose of availing the discounts granted by law to Senior Citizens.

JUAN DE LA CRUZ
Brgy. Cambagahan, Bais City
Negros Oriental
Senior Citizen ID No. 0

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