REPUBLIC OF THE PHILIPPINES )

CITY OF MAKATI ) s.s.

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

<Company name> with business address at <Company address>, acting through its
duly authorized officer, <authorized representative>, <position of authorized
representative>, has named, constituted and appointed <appointee’s company name>,
namely: <appointee’s representative/s or name/s> with business address at <address>,
or any of its authorized representatives, as its true and lawful Attorney-in-Fact for and in its
name, place and stead, to <purpose of SPA>.

HEREBY GIVING AND GRANTING unto said Attorney-in-Fact full power and
authority to do and perform all and every act and thing whatsoever requisite and necessary
to be done in and about the premises and HEREBY RATIFYING AND CONFIRMING all that
said Attorney-in-Fact shall lawfully do or cause to be done by virtue of this Special Power of
Attorney.

The rights, powers and authority of said Attorney-in-Fact to exercise any and all of
the rights and powers herein granted shall commence and be in full force and effect upon
execution of this Special Power of Attorney and shall remain in full force and effect until
XXXX, or unless specifically extended or revoked earlier in writing by either party.

IN WITNESS WHEREOF, I, <Authorized Representative>, in my capacity as the

<Position of Authorized Representative> of <company name> have signed these
presents this ___ day of ____________ at _________________.

______________________________
<Authorized Representative>
<Position of Authorized
Representative>

Page 1 of 2
<Company name>
Special Power of Attorney (SPA) to <appointee’s name>
 SIGNED IN THE PRESENCE OF:

______________________ ______________________

ACKNOWLEDGMENT

SUBSCRIBED AND SWORN to before me this ___ day of _________ in

______________, affiant exhibiting to me his/her ____________ No. _____________
issued on _____________ at _____________ and valid until _____________, known to be
and to me known as the same person who executed the foregoing instrument and he/she
acknowledged to me that the same is his/her voluntary act and deed and that of the
corporation hereby represented.

This Special Power of Attorney consists of two (2) pages, including the page
whereon this acknowledgment is written and has been signed by the party executing this
instrument and her witnesses and sealed with my notarial seal.

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

NOTARY PUBLIC

Doc. No. _____;

Page No. _____;
Book No._____;
Series of _____.

Page 2 of 2
<Company name>
Special Power of Attorney (SPA) to <appointee’s name>