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Special Power of Attorney

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Republic of the Philippines)

City of ________________) S.S.

_______________________________)

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _________________, of legal age, single, residents


of________________________________ ____________________________________, do
hereby name, constitute and appoint Mrs. _________________, of Legal, married, resident(s) of
___________________________________

to be my true and lawful attorney-in-fact for me, and in my name, place and stead, to do and
perform the following acts, to wit:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite or necessary or proper
to be done in and about the premises as fully to all intents and purposes as I might or could
lawfully do if personally present, with power of substitution and revocation, and hereby ratifying
and confirming all that my said attorney-in-fact shall lawfully do or cause to done under and by
virtue of these presents.

IN WITNESS WHEROF, I hereby set my hands this ________day of ________,


CY________ in ___________________________________________.

______________________________

PRINCIPAL

Signed in the Presence of:

______________________ ______________________ ______________________

SUBBSCRIBED AND SOWRN TO BEFORE ME, this ____th day of _________2018 at


________________, _______. Affiant exhibiting her _______________ issued on _________
2018 at ____________.

Doc. No. ______; NOTARY PUBLIC


Page No. ______;
Book No. ______;
Series of 2018

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