Republic of the Philippines )

) S.S

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _________________________, Filipino and resident of ____________________, do hereby

name and appoint __________________________a corporation duly organized and existing under the
Philippine laws with principal office at _________________________ through its legal and authorized
representative __________________ to be our true and lawful attorney-in-fact for us, and in our name, place
and stead, to do and perform the following acts and deeds, to wit:

1. To cause the parcelization pursuant to DAR Administrative Order No. Series of

2019 of Collective CLOA Title No. ___ located at Brgy. Magcaraguit, Dimasalang,
Masbat, which I am a beneficiary of;

2. To submit the supporting documents in furtherance of the parcelization of

Collective CLOA Title No. ____ and in accordance with Section 11, 12, 13 and 14
of DAR Administrative Order No. Series of 2019;

3. To make, sign, execute, deliver and receive contracts, agreements, and any and all
documents and other writing of whatever nature or kind, as may be necessary to
carry into effect the foregoing authority and to bind myself in any covenant with
DAR and all other agencies concerned;

4. To perform any and all relative matter for the fulfillment of the given authority.

HEREBY GIVING AND GRANTING unto our 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 we might or could lawfully do if personally present,
with power of substitution and revocation, and hereby ratifying and confirming all that our said attorney-in-
fact shall lawfully do or cause to done under and by virtue of these presents.

IN WITNESS WHEREOF, we hereby set our hands this ______________________in

____________________.

Principal

Attorney-in-fact

SIGNED IN THE PRESENCE OF:

Witness Witness

Page 1 of 2
 ACKNOWLEDGMENT
Republic of the Philippines )
) S.S.

BEFORE ME, this _____________ personally appeared the following persons, to wit:

Name Passport/License No./ID Date/Place of Issue

known to me and to me known to be the same persons who executed and signed the foregoing
Special Power of Attorney consisting of two (2) pages including this page, signed by the parties and
the instrumental witnesses on the last page and at the left hand margin of each and every page
thereof; and the parties acknowledged to me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and place first above written.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2020.

Page 2 of 2