REPUBLIC OF THE PHILIPPINES_______)

CITY OF CEBU______________________)S.S.

________________________________)

SPECIAL POWER OF ATTORNEY To Print

I ____________________, hereby name, appoint and constitute _______ represented

____________, to be my true and lawful attorney, to act on my behalf and in my name, to
execute and perform all or any of the following acts, deeds, matters and things, in connection
with, to wit:

HEREBY GIVING AND GRANTING unto our said attorney full powers and authority to do and
perform all and every act 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 her substitute shall lawfully do or cause to be done by virtue hereof, TO PRINT 12
OF SERVICE INVOICE STUBS UNDER TIN NUMBER __________________.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of _________ 2024, in CEBU
CITY.

_______________________

By:

________________________________

AFFIANT

IN WITNESS WHEREOF, I have placed my hand and seal on the date and at the place first
above-written.

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