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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I,______________, of legal age, Filipino, with residence and postal address


at _______________________, by these presents hereby NAME, APPOINT and
CONSTITUTE ________________________, of legal age, Filipino, with residence
and postal address at ____________________, to do and perform the following
acts, to wit:

1.

2.

3.

HEREBY GIVING AND GRANTING unto my said Attorney-in-fact full


power and authority to perform each and every act requisite or necessary to
carry into effect the foregoing authority, as to all intents and purposes as I
might or could do if personally present, and 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 hereunto set my hand this ___day of


___________ in the ______________, Philippines.

PRINCIPAL ATTY-IN-FACT

Signed in the presence of:

______________________________ ______________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF MARINDUQUE ) SS.

BEFORE ME, a Notary Public, for and in the (place______________,


Philippines, this ___day of _____________, personally came and appeared
_____________________with his (competent proof of identity), known to me to be
the same person who executed the foregoing instrument and acknowledged to
me that the same is his voluntary act and deed.

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

D
P
B
S

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF MARINDUQUE ) SS.

BEFORE ME, a Notary Public, for and in the ________, Philippines, this __
day of ___________, personally came and appeared ___________ with (competent
proof of identity), known to me to be same person who executed the foregoing
instrument and acknowledged to me that the same is his voluntary act and
deed.

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

D
P
B
S

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