45 Tindalo St., Brgy.

Claro,
Project 3, Quezon City

May 18, 2015

MR. GERONIMO V. FRANCISCO

President and Chief Operations Officer,
Fortune Medicare, Inc.
3rd Floor, Citystate Centre, 709 Shaw Blvd.,
Pasig City

Attention: Cancellations Department

Fortune Medicare, Inc.
Subject: Cancellation of Health Care Program

S i r:
We, spouses, PAUL PATRICK BLANCO y SEOREN, under contract number HO-151177388 and KRISTINE JOYCE BLANCO y MARZAN, under contract number HO-15-1178443,
would like to inform you that we decided to terminate our health insurance coverage effective
immediately. We would appreciate if you could send us a written confirmation of the

cancellation for our records at your earliest convenience.

Thank you and we hope you will consider this request and put into effect as soon
as possible.
Sincerely yours,

PAUL PATRICK S. BLANCO

KRISTINE JOYCE M. BLANCO