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CERTIFICATION
TO WHOM IT MAY CONCERN:
THIS IS TO CERTIFY that per records in this office, Mr./Ms. _________________
__________________________________ of the ______________________________________
this University is an employee of the said office/unit on _________________________ status.
This is to certify further that the following is/are his/her registered dependent
As of _______June________ , 2013 to wit:
NAME/S
RELATIONSHIP
1.
2.
3.
__________________
Acting Director
Verified by: __________________________