PROXY

KNOW ALL MEN BY THESE PRESENTS:

That I, _____________, Filipino, of legal age, (single / married / widow), and a

resident of _____________, Philippines, do hereby constitute and appoint
__Name of Proxy__, who is also of legal age, Filipino, (single / married / widow),
and a resident of _____________, Philippines, to represent me and vote the
__________________________ (_________) shares of the capital stock
appearing in my name at the Annual Stockholders Meeting of __Name of
Corporation__, INC. to be held on _____________.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at

the City of _____________, Philippines.

STOCKHOLDER

Accepted by:

PROXY

SIGNED IN THE PRESENCE OF:

__________________ __________________

(ACKNOWLEDGMENT)