SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ________________, Filipino, of legal age, a resident ______________, do hereby appoint and
constitute _______________, Filipino, of legal age, married to _______________ to be my true and
lawful attorney, to act on my behalf and in my name, to execute and perform all of the following
acts, deeds, matters and things, in connection with motor vehicle which is more particularly
described as follows:

MAKE MOTOR NO.

SERIES SERIAL/CHASSIS NO.
TYPE OF BODY PLATE NUMBER
YEAR MODEL FILE NUMBER
CERTIFICATE OF REGISTRATION NUMBER

HEREBY GIVING AND GRANTING unto our said attorney full powers and authority to do, perform
and transact all and every act of requisite or necessary to carry into effect the foregoing powers, as
fully to all intents and purposes as I might or could lawfully do if personally present, with full power
of substitution and revocation, and hereby ratifying and confirming all that my said attorney or his
substitute shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, we have hereunto affixed our signatures on this ___day of ________2023 at
_________________________________, Philippines.

__________________________ __________________________

VENDOR Appointee/Attorney-In-Fact

Signed in the presence of:

__________________________ __________________________
 ACKNOWLEDGEMENT

Republic of the Philippines)

) S.S

BEFORE ME, personally appeared:

Name ID NO. Place Issued

Known to me and to me known to be the same persons who executed the foregoing instrument and
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.

Notary Public

Doc. No._______;
Page No._______;
Book No._______;
Series of 20_____.