[ COMPANY LETTERHEAD]
[ DATE ]
[ EMB REGIONAL DIRECTOR’S NAME ]
Regional Director
ENVIRONMENTAL MANAGEMENT BUREAU REGION [ NUMBER ]
[EMB REGIONAL OFFICE ADDRESS]
SUBJECT
:
AUTHORIZATION
I, the undersigned, _______________________________ with the following ID’s
Gov’t ID # :
_____________________ ,
Company ID # :
______________________ ,
Hereby authorize MR/MRS. _________________________________ with the following ID’s
Gov’t ID # :
_____________________ ,
Company ID #:
______________________,
to act on my behalf in all manners relating to the application, submission and processing in the EMB
Online services of our Company / Facility Name : ______________________________ which is
located in ______________________________________________. Any and all acts carried out by
Mr./Mrs. _________________________________________ on my behalf shall have the same effect
as acts of my own.
Hoping for your kind consideration
Thank you.
[ Signature over Printed Name ]
Senders Name
Contact Number
Photocopy of Senders ID attachment
SENDERS
GOVERNMENT ID SAMPLE
SENDERS
COMPANY ID SAMPLE