Int-F-1 Purok Bajada, Sinsuat Avenue

Mother Barangay Rosary Heights

Cotabato City, 9600

December 17, 2016

THE MANAGER
KAISER International Health Group, Inc.

Sir/Madame:

Greetings of peace!

We would like to formally request your good office that all death benefits/claims of our late father,
Teodoro Du Esmundo, under the Group Hospitalization Insurance Program (GHIP), whether in cash or
check(s), be payable to Decerie Jean Ibot Esmundo.

We have arrived with this decision for it is most convenient and practical for all of us.

Should you wish to clarify anything, you may contact us at 09168577819.

Hoping that this request merits your generous approval.

More power and God speed!

Respectfully,

Jacqueline Esmundo Barrios

Oliver Ibot Esmundo

Nick James Ibot Esmundo

Decerie Jean Ibot Esmundo