SAMPLE SPA IN RELATION TO REQUESTS FOR OFFICIAL TRANSCRIPT OF RECORDS

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, REYNELYN T. GILLADO, of legal age, single, Filipino citizen and resident of
ESPERANZA INOPACAN LEYTE, do hereby name, constitute and appoint do hereby
appoint, name and constitute my Friend, KIA MAE AGTUTUBO, of legal age, single, Filipino
citizen,and resident of KORONADAL, SOUTH COTABATO, 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:

To CLAIM and RECEIVE from MINDANAO STATE UNIVERSITY-

GENERAL SANTOS CITY
my DIPLOMA and TRANSCRIPT OF RECORDS (TOR).

To sign and execute in my behalf any and all papers and documents, andto do and
perform any and all acts and things which may be requisite,necessary or proper to
carry out the above-purposes.

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary or proper to be done in and about the request as fully to all intents and
purpose as I might or could do if personally present and acting in person; and

HEREBY RATIFYING AND CONFIRMING all that my said attorney-in-fact shall

lawfully do and cause to be done under by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand at ____________, Philippines,

on this ____________ day of ________________, 20______.

REYNELYN T. GILLADO
Principal

KIA MAE AGTUTUBO

Attorney-in-fact

Signed in the presence of:

Page 1 of 2
SAMPLE SPA IN RELATION TO REQUESTS FOR OFFICIAL TRANSCRIPT OF RECORDS

_ NAME OF WITNESS___ ____NAME OF WITNESS___

ACKNOWLEDGMENT

Republic of the Philippines

Cebu City ) S.S.

BEFORE ME, a Notary Public in and for ________________, Philippines, this

___________________ personally appeared:

Name Valid ID Date/Place Issued

_______________________ _________________
___________________________

_______________________ _________________ ___________________________

known to me to be the same persons who executed the foregoing instrument and they
acknowledged to me that the same is their free and voluntary act and deed.

IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my notarial seal on

the date and at the place first above written.

Doc No. _________

Page No._________
Book No. ________
Series of 20_______

Page 2 of 2