SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

THAT I, ____________________________________, Filipino citizen, of legal

age, married to _________________________________ and resident
of ____________________________ do hereby appoint, name and constitute
________________________________________, _________ citizen, of legal age,
single/married and resident(s) of
________________________________________________________ to be my true
and lawful attorney to act in, manage and conduct all my affairs and for that purpose in
my name and on my behalf to do and execute any or all of the following acts, deeds,
and things, to wit:

1. To process, claim, receive and collect from

___________________________________________ any and all sums of
money which now or hereafter become due me as:

( ) pension ( ) salary
( ) allowances ( ) other ________

and to endorse the same if they are in the form of checks, for encashment or deposit in
a bank under my account.

2. To transact, follow-up, and sign all papers regarding said claim;

3. To sign any document in my behalf, in connection hereto; and
4. To do all acts necessary to be done.

HEREBY GIVING AND GRANTING unto my said attorney full power and
authority whatsoever requisite or proper to be done in or about the premises, as fully to
all intents and purposes as I might or could lawfully do if personally present, and hereby
certifying and confirming all that my said attorney shall do or cause to be done under
and by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand this _________ day

of ______________ at _______________________.

__________________________
Principal

With my confirmity:

________________________
Attorney-in-fact

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 Signed in the presence of:

___________________________ ___________________________

ACKNOWLEDGMENT

Republic of the Philippines )

City of _____________________ ) S.S.
x------------------------------------------------------x

BEFORE ME, a Notary Public for and in the city of _________________ this
_________ day of ______________ personally came and appeared
_______________________ with Passport No. 12345678 issued on 08 June 2018 in
Manila known to me to be the same person who executed the foregoing Special Power
of Attorney and acknowledged to me the same is his/her free and voluntary act and
deed.

WITNESS MY HAND AND NOTARIAL SEAL

Doc. No. _____

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

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