Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 2

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

We, ROSEAGARIN, all of legal ages, all married, American citizens and
and Canadian citizens, residents of San, Jose y, do hereby appoint, name and
constitute, MMBA, Filipino citizen and a resident of Brgy. 2e, Philippines, to be
our true and lawful Attorney-in-Fact to do and execute the following acts in our
name on our behalf to wit:

1. To process, claim and receive all benefits owing to our late father,
ALFREA from Government Service Insurance System (GSIS);
2. To transact, follow-up, and sign all papers regarding said claim;
3. To sign any document in our behalf, in connection hereto; and
4. To do all acts necessary to be done.

HEREBY GIVING AND GRANTING, unto our said Attorney-in-Fact, full


power and authority to do all and every act, requisite or necessary to be done
under the premises in order to carry into effect the foregoing authority and
HEREBY CONFIRMING AND RATIFYING all and our said Attorney-in-Fact,
shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, we have hereunto set our hands this


________________ at Laoag City, Philippines.

______________________ ________________________________
ROSG MARLOAGA
ID#: B40008 DL#: H0004

________________________________ _____________________
ANTONIRIAGA DOLOARIN
DL#: MA-DA-\3DL DL#: -*427BU

Principals

I accept:

MMBA
UMID#: 0001-2
Attorney-in-Fact

SIGNED IN THE PRESENCE OF:

____________________________ ________________________

REPUBLIC OF THE PHILIPPINES )


CITY OF ) s.s
BEFORE ME, this ____________________, at City, Philippines, personally
appeared the above-cited parties with their proof of identities indicated below
their respective names and signatures, known to me and to me known to be the
same persons who executed the foregoing instrument of Special Power of
Attorney, and acknowledged to me that the same is their free and voluntary
act and deed.

WITNESS MY HAND AND SEAL, on the day, year and place first above-
written.

You might also like