SPECIAL POWER OF ATTORNEY

I, __________________ Filipino, of legal age, with address at

_______________________, hereinafter referred to as the “Grantor” hereby name, appoint and
constitute Atty. Jacob D. Ballos with office address at 201 CG Bldg., Aguirre St., Legaspi
Village, Makati City, hereinafter referred to as the “Grantee” to be our true and lawful attorney,
to act on our behalf and in our name, to execute and perform all or any of the following acts,
deeds, matters and things, in connection with the request for BANK CERTIFICATION FOR
VISA PURPOSES WITH AVERAGE DAILY BALANCE (ADB) OF MY BPI ACCOUNT
WITH NO. ___________________; _______________ BRANCH.

1. To represent the Grantors in all respect in connection with the processing of

the request for the above transaction;

2. To sign, execute, acknowledge, receive, and deliver such payments, papers

and instruments as may be necessary in connection with the above-described
under reasonable terms and conditions acceptable to our said attorney-in-fact;
and

4. To do such any other act or thing that may be required necessary or incidental
to carry out effectively any and all of the purposes for which this authority is
hereby given.

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 his substitute shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of _________ 2023, in
__________________.

__________________
Principal

Conforme:

Atty. Jacob D. Ballos

Signed in the presence of:

__________________________ __________________________

1
 ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

_______________________________) S.S.

BEFORE ME, a Notary Public for and in the __________, this ___________________,
personally appeared the following:

NAME Competent Evidence of Identity

___________________ _________________________
___________________ _________________________

known to me and to me known to be the same person/s who executed the foregoing General
Power of Attorney consisting of two (2) pages including the page on which this
Acknowledgment is written, and who acknowledged to me that the same is their free and
voluntary act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand on the date and place above written.

Doc. No.:____;
Page No.:____;
Book No.:____;
Series of 2023.