SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _______________________________________________________________________________, Filipino, of legal
age,
single
/
married
and
with
office
address
at
___________________________________________________________
_________________________________________________________, being the registered owner and sole
proprietor of
________________________________________________________(the Firm), duly registered with the
Department of
Trade
and
Industry,
hereby
appoint,
____________________________________________________________________,
whose name(s) and signature(s) appear(s) below, as my Attorney(s)-in-Fact with full power and
authority
singly
/
jointly /
__________________________________, to:
(a) sign, execute, and/or deliver any and all documents in connection with my deposit
account(s) with Sterling Bank of Asia (the Bank), details as follows:
Type of Account
______________________

Account Number

Branch

_________________________

____________________________
______________________

_________________________

____________________________
______________________

_________________________

____________________________
(b) withdraw my funds/monies in said account(s) by checks, receipts, drafts, bills of
exchange, withdrawal slips, order for payments or otherwise; and
(c) sign, endorse, draw, accept, make, execute, and/or deliver for negotiation, payment,
deposit or collection checks, receipts, drafts, bills of exchange, order of payment, and/or
other similar instruments issued by or to the Firm.
NAME

SIGNATURE

1. ___________________________________________

_____________________________________

2. ___________________________________________

_____________________________________

3. ___________________________________________

_____________________________________

The foregoing authority shall be valid for one (1) year from the date of its effectivity.
HEREBY GIVING AND GRANTING unto my said Attorny(s)-in-Fact full power and authority to do
and perform every act and thing requisite and necessary to be done in and above the premises,
hereby ratifying and confirming all that my said Attorney(s)-in-Fact may do or lawfully cause to
be done under and by virtue of these presents.
IN WITNESS WHEREOF, I have hereunto affixed my signature this _____________ day of
______________, 20 _______ at
____________________________________.
________________________________________
Signature of Principal Over Printed Name
SIGNED IN THE PRESENCE OF:
________________________________________________
_______________________________________________
A C K N O W L E D G E M E N T
REPUBLIC OF THE PHILIPPINES)
)SS
BEFORE
ME,
a
Notary
Public
personally
__________________________________________________________,

appeared

with Community Tax Certificate / Passport No. _____________________________ issued on

_____________________ at
_______________________________________, known to me and to me known to be the same person
who executed the foregoing Special Power of Attorney, and he/she acknowledged to me that the
same is his/her free and voluntary act and deed.
WITNESS MY HAND AND SEAL on this __________day of _______________________, 20_ at the place
first above written.
Notary Public
Doc. No.
_____________;
Page No.
_____________;
Book No.
_____________;
Series of
_____________.
LMD 01/2012