The Board of Trustees

The Hotel Industry

Ilwu Pension Plan
1440 Kapiolani Blvd; Suite 800
Honolulu, Hawaii 96814

February 05, 2018

Dear Sir/ Madam

I am writing you this letter in regards to my 2018 Annual Affidavit.

I wish to inform you that right now I’m on my doctor’s professional care
due to my previous ailment that has been bothering me for many years.
I’m very sorry to inform your good office that my left knee is still in worse
situation so with my left shoulder was affected that cause me too much pain.
Aside from my current ailment, I was also diagnose with other ailment as
shown on my doctors note. So I was advice to have more medical assistance
that I need to go to my doctor every week for follow-up check-up.
So up to this time, I can’t sleep good and I have a suspicious maybe due
to my anemia which cause me weak and unhealthy.
I’m not able to go for a long travel to Manila at the U.S. Embassy
inforont of U.S. Notary Public due to my present condition.
I pray for any consideration rendered.
Thank you,

DOMINADOR C. MORALES
Beneficiary
 Republic of the Philippines
Province of Cagayan
Municipality of Sanchez Mira
Northern Cagayan District Hospital

MEDICAL CERTIFICATE

To Whom It May Concern:

This is to inform that a 79 years old man Mr. DOMINADOR C.

MORALES is a regular patient in this hospital.

He was brought again in this hospital on January 29, 2018 for he is

suffering severe pain of his gouty arthritis and was released January 31, 2018.
The patient was given immediate medical treatment. The patient also
undergo Laboratory Test for complete blood count.

The laboratory result shows he has Hypertension, High uric acid,

creatinine and anemia.

The patient need long term medical treatment due to his multiple ailment
and was adviced to have follow-up check-up weekly until its needed.
As to the present health situation of the patient he is weak and it is
impossible for him to have a long travel to Manila at the U.S. Embassy infront
of a U..S. Notary Public to complete his annual affidavit at this time.

Any consideration due to the patient is very much appreciated.

Given by hand this 4th day of February, 2018 at the Sanchez Mira,
Cagayan Philippines.

Attending Physician
PTR #____________