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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, MICAH A. COÑEJOS, of legal age, Filipino, married, with residence address at B-


128 L-25 Mabuhay City, Paliparan, Dasmariñas Cavite, have named by these presents do hereby
name, appoint and constitute ROSEMARIE B. UGDAMINA, of legal age, Filipino, with
residence and postal address at 6711 Sto. Niño, Western Samar, to be my true and lawful
attorney-in-fact, for me and in name, place and stead, to do and perform the following acts:

1. To authorize to secure “change of name” of my Birth Certificate;

2. To sign and execute any papers/documents which may be deemed necessary to give full
force and effect to the foregoing authority and other purposes.

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

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of


________________ 2007 at Quezon City, Philippines.

MICAH A. COÑEJOS ROSEMARIE B. UGDAMINA


Principal Atty-In-Fact

SIGNED IN THE PRESENCE OF:

1. __________________________ 2. ________________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES )


) S.S

BEFORE ME, a Notary Public for and in Quezon City on this _____ day of
__________________ 2007 personally appeared MICAH A. COÑEJOS with CTC/Passport
No.___________________ issued on ___________________ at __________________ and
ROSEMARIE B. UGDAMINA with CTC/Passport No.___________________ issued on
___________________ at __________________ , known to me to be the same person who
executed the foregoing instrument and acknowledge to me that the same is his/her free act and
voluntary deed.

WITNESS MY HAND AND SEAL on the date and place first above written.

NOTARY PUBLIC
Doc. No.: ______
Page No.: ______
Book No.: ______
Series of 2007

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