May 24, 2017

BIR Revenue District Office No. 24

JRC Bldg., Mc Arthur Highway,
Malinta, Valenzuela City

Madam/Sir:

I, (Name), hereby authorize, __________________________, to act on my behalf

with regards to my application for Change of Registered Address. For security
purposes, I have attested below my own signature and the signature of the authorized
person.

I appreciate your assistance in this matter. Thank you.

Sincerely,

Name