SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _______________________________, of legal age, single/married,
Filipino, with residence at _________________________________, Philippines
do hereby NAME, CONSTITUTE, APPOINT AND AUTHORIZE FUNDACION
GRAMEN PILIPINAS, INC. as my true and lawful Attorney-In-Fact, for me and in
my name, place and stead, to do and perform the following act, to wit:
1. To deduct from my salary an amount intended for the payment of my salary
loan until my loan is fully paid;
2. To sign papers and documents related to the said act;
3. To do any act which carry this authority into effect.
HEREBY GIVING AND GRANTING unto my said Attorney full powers and
authority to do and perform all and every act requisite or necessary to carry into effect
the foregoing authority to all intents and purposes as I might or could lawfully do if
personally present, with full power of substitution and revocation, and hereby ratifying
and confirming all that my said attorney shall lawfully do or cause to be done by virtue
thereof.
IN WITNESS WHEREOF, I have hereunto set my hand this ____________
at Catarman, Northern Samar, Philippines.
__________________________
Principal
Signed in the presence of:
___________________
Witness
Republic of the Philippines
Province of Northern Samar
Municipality of Catarman

___________________
Witness

S.S.

BEFORE ME, this _____________ at Catarman, Northern Samar personally

appeared __________________________ exhibiting to me his/her _____
_________________________, as competent proof of identity, known to me to
be the same person who executed the foregoing Special Power of Attorney which he/she
acknowledged to me that the same is his/her free and voluntary act and deed.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2014.