10-ELEVEN S T O R E

ACCREDITED LBP CASH OUT FACILITY MERCHANT

123 Bldg. Tacloban City

July 19, 2017

C E R T I F I C A T I O N

This is to certify that the DSWD CASH CARD of _______________ is currently

under our safekeeping and custody due to erroneous transaction that happened on
July 19, 2017, we being a LANDBANK POS CASH OUT FACILITY MERCHANT under
LBP __________________________. Such retention is necessary for the
reversal/correction of the erroneous transaction as per advice of the LBP Bank
Manager. The period of retention will be only for the duration of the said
reversal/correction process and would be immediately be returned once it is
cleared for return.
Issued upon request by card holder in lieu of actual card exhibition or
presentment when called upon by the DSWD personnel, staff or employees, to avail
of other benefits other than actual card usage for the period his/her Cash Card is
under bank process and for any other purpose this may serve.

JUAN DELA CRUZ

PROPRIETOR/LBP POS MERCHANT

CARD DETAILS:
CARD NAME: JOHN SNOW
CARD NO.: XXXXXXXXXXXXXX