SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ___________________ , Filipino, legal age, single and a resident of

____________________________, do hereby NAME, CONSTITUTE and
APPOINT _________________, Filipino, legal age, single, and a resident of
______________________________R to be my true and lawful attorney-in-fact,
for me and in my name, place and stand and for my own benefit to do and
perform all or any of the following acts and things, namely:

1. To CLAIM and RECEIVE my Philippine Passport from the office of

Department of Foreign Affairs - South Alabang - ATC;

2. To sign, execute, deliver and submit all documents and papers, and
perform all acts may be necessary and expedient for said purpose;

3. To perform such acts as maybe necessary and required in the

execution and accomplishment of the powers given to him.

GIVING AND GRANTING unto my 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, as fully to all intents and
purpose as We 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
by virtue of these presents.

IN WITNESS WHEREOF, We have hereunto affixed my signature this

__________ in Roxas City.

______________
Principal

SIGNED IN THE PRESENCE OF:

_________________________ _________________________

ACKNOWLEDGEMENT

1
REPUBLIC OF THE PHILIPPINES)
CITY OF ROXAS ) S.S
x------------------------------------x

BEFORE ME a Notary Public for and in the_______________ and

Province of ______________, this___________, personally appeared the above-
named with her competent proof of identity whom is personally known to the
Notary Public or identified by the Notary Public through competent evidence of
identity as defined by the Notary Public through competent evidence of identity
as defined by the 2004 Rules on Notarial Practice pursuant to Supreme Court EN
BANC A.M. No. 02-8-13 SC Resolution. That the herein person represented to the
Notary Public is the same person who executed and signed the foregoing
instrument and acknowledged to me that same is her voluntary act and deed.

This Special Power of Attorney is consisting of two (2) pages, including this page
where the acknowledgement is written and signed by the parties together with
their instrumental witnesses on each and every page.

WITNESS MY HAND AND SEAL.

Doc. No.______
Page No.______
Book No.______
Series of 20____.