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Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A (CALABARZON)
DIVISION OF CAVITE

November 8, 2016

The Manager
Fortune Life Insurance Co.
Dasmarias, Cavite

Sir/Madam:

This is to follow up my request to cancel my contribution to Fortune Life Insurance Co.


(Code No. 142C) with effect from April 2016. I would appreciate if you could send me a
written confirmation confirming that the cancellation has been accepted and put into
effect. I also request you to refund the unused portion of my policy premium.

Thank you and I hope you will consider this request and put it into effect as soon as
possible.

Respectfully yours,

_______________________
CHRISTIAN RACEL R. PEJI
Teacher I

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