REPUBLIC OF THE PHILIPPINES)

) S.S.

SPECIAL POWER OF ATTORNEY

COUPLED WITH INTEREST

KNOW ALL MEN BY THESE PRESENTS:

I, ________________________ Filipino, of legal age, single/married, with

address at _______________________, do hereby name, constitute and appoint
___________________________, Filipino, of legal age, with address at
____________________, to be my true and lawful attorney, for me and in my name,
place and stead, to do and perform all or any of the following acts, deeds and things, to
wit:

1. To exercise general control and supervision over my deposit

accounts described in detail in the attachment designated as Schedule I (the “Deposits”),
and to act as my general representative and agent, with full authority to make deposits,
transfers, withdrawals, write, make and endorse checks, drafts and other instruments in
connection with my bank accounts;

2. To ask, demand, sue for, recover and receive all sums of money,
debts, dues, goods, merchandises, effects and things of whatsoever nature or description
which now or hereafter shall be to become due, owing, payable, or belonging to me in or
by any right, title, ways or means whatsoever, and upon receipt thereof or of any part
thereof, to make, sign, execute, and deliver such receipts, releases, or other discharges for
the same respectively as she shall think fit to be advised;

3. To utilize such deposits to buy, or otherwise acquire any property,

personal, shares of stock, land, improvements, real or mixed, of any kind whatsoever and
wheresoever, situated, or any interest therein, upon such terms and conditions and under
such covenants as my said attorney shall deem fit and proper, and to execute in my name
any and all papers relating thereto and to sign, execute, acknowledge and deliver any and
all agreements or other writings therefore, or in any way connected therewith;

4. To borrow or lend any sum or sums of money on such terms,

conditions and stipulations and on such security, as my attorney may think fit for that
purpose; to execute all promissory notes, bonds and other instruments which may be
necessary and proper;

5. To settle any account or reckoning whatsoever wherein I know am,

or at any time hereafter shall be in any wise, interested or concerned with any person
whomsoever, and to pay or receive the balance thereof as the case may require;

6. To make, sign, seal, execute and deliver contracts, documents,

agreements and other writings or whatever nature or kind, with any and all third persons,
concerns or entities upon terms and conditions acceptable to my said attorney;

8. In general to do all other acts, deeds, matters, and things whatsoever in or

about my estate, property, and affairs, or to concur with persons jointly interested with
myself therein in doing all acts, deeds, matters, and things herein, either particularly or
generally described, as fully and effectually to all intents and purposes as I could do in
my own proper person if personally present.
 HEREBY declaring this power of attorney as one coupled with an interest, and
GIVING AND GRANTING unto my said attorney-in-fact full power and authority to do
and perform every act and thing whatsoever requisite and necessary to be done in and
about the premises, as fully to all intents and purposes as I might or could do if personally
present, hereby ratifying and confirming all that my said attorney, shall lawfully do or
cause to be done by virtue of these presents.

This power of attorney is constituted in the common interest and benefit of myself
and of my duly appointed attorney-in-fact and my heirs.

[place], Philippines, ___________ 2017.

______________________

Accepted by:

_______________
Attorney-in-fact

SIGNED IN THE PRESENCE OF:

______________________ _______________________

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the above jurisdiction, this ______ day of
_____________ 2017, personally came and appeared _________________ with community
tax certificate no. ___________ issued on ___________ at ____________, personally
known to me and to me known to be the same person who executed the foregoing
instrument which he acknowledged before me as his free and voluntary act and deed.

WITNESS MY HAND AND SEAL this _____ day of ________ 2017 at

_____________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017.