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    Authorization of Psa

    Uploaded by

    Rechelle Cafe

    Copyright:

    © All Rights Reserved
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    Authorization of Psa

    Uploaded by

    Rechelle Cafe
    35 views1 page

    Original Title

    AUTHORIZATION OF PSA

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as docx, pdf, or txt
    35 views1 page

    Authorization of Psa

    Uploaded by

    Rechelle Cafe

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Date: _____________________

    To whom it may concern,

    This is to authorize ___________________________ my _______________,

    of legal age, resident of ____________________________________, to secure in my behalf

    my _________________ PSA Issued ______________________________________ for the

    purpose of _______________________________.

    With the following details:

    NAME: ___________________________________________________________________

    DATE OF BIRTH/DEATH/MARRIAGE: ______________________________________

    PLACE OF BIRTH/DEATH/MARRIAGE: _____________________________________

    NAME OF MOTHER: _______________________________________________________

    NAME OF FATHER: _______________________________________________________

    NO. OF COPIES: __________________

    VALID ID PRESENTED (OWNER): __________________________________________

    VALID ID PRESENTED (AUTHORIZE PERSON): _____________________________

    Attached herewith are photocopies of my ID and the ID of the person I authorized.

    ________________________ _______________________________
    Owner’s Name and Signature Authorize Person’s Name and Signature

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