PSA Authorization Letter

Printable template for authorizing a representative in the Philippines to request PSA documents on your behalf.

Processed under the legal authority of Atty. George M. Garvida

PSA Authorization Letter

Print this template, complete it by hand, sign, and email with your PSA application and passport copy to admin@explorebeyondborders.ca.

PSA authorization template. General document facilitation only — not legal advice. Final letter must be handwritten and signed. PSA government fees apply separately at the outlet in Philippine Pesos. This does not guarantee PSA issuance or document delivery.

Form PSA-AUTH-2026-07 · Philippine Statistics Authority authorization template

PSA Authorization Letter — Blank Template (Fill in by hand)

Instructions

Write this letter by hand on a clean sheet of paper, or print this page and fill in the blanks with a pen. Sign at the bottom. Scan or photograph the signed letter and email it with your signed PSA application form and passport copy.

PSA Birth Application PSA Marriage Application PSA CENOMAR PSA CENODEATH

(City/Town), Canada
Date:

To Whom It May Concern:

Philippine Statistics Authority (PSA)
Serbilis Center / PSA Main Office
Quezon City / Manila, Philippines

AUTHORIZATION LETTER

I, (full name), of legal age, Filipino citizen, currently residing at (complete address in Canada), hereby AUTHORIZE (representative's full legal name — fill in by hand), as my direct representative in the Philippines, to act on my behalf in requesting, claiming, and receiving the following PSA document/s:

Type of Document: (☐ Birth Certificate ☐ Marriage Certificate ☐ CENOMAR ☐ CENODEATH)

Name on Document:

No. of Copies: Purpose:

This authorization is granted for the sole purpose of requesting and receiving the above-mentioned PSA document/s. The authorized representative is permitted to present this letter along with a photocopy of my valid passport as proof of my identity and authority.

I am granting this authorization because I am currently residing outside the Philippines and am unable to personally transact at the PSA office.

This authorization is valid for a period of six (6) months from the date of signing, unless revoked earlier in writing.

Thank you for your kind assistance.

Sincerely,

Signature of Authorizing Party

Printed Full Name

Date Signed

Contact Number:
Email Address:

Attached:

☐ Photocopy of Philippine Passport (data page)
☐ PSA Application Form (signed)