Special Power Of Attorney_form.docx

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, __________________., of legal age, Filipino, and with residential address at _________________________, do hereby name, constitute and appoint __________________________, of legal age, and with postal address at _____________________________________________________, to be my true and lawful agent and Attorney-in-Fact for me in name, place and stead, to do and perform the following acts, to wit: 1. 2. 3. 4.

To ask, collect and receive all sums of money either in cash or check(s) payable to me from ___________________________; To execute, sign, and process my paycheck to be deposited in my bank account _______________________, and to sign and acknowledge the receipt; To sign and execute any and all papers with all and any third persons, concerns and entities in connection with the above-given powers; That the Special Power of Attorney shall remain in force and in effect until further written notice from the Principal.

HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and authority to do and perform each and every act which may be necessary or convenient, in connection with any of the foregoing as fully to all intents and purposes 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 may also 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 ______________ 2018 in ____________________.

___________________________. Principal

SIGNED IN THE PRESENCE OF:

_________________________

_________________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES) _______________________________

) S.S.

BEFORE ME, a Notary Public for and in _____________, this ________ day of ___________ 2018, personally appeared the above-named person, who has satisfactorily proven to me her identity through her identifying document written below her name and signature, that they are the same person who executed and voluntarily signed the foregoing Special Power of Attorney, duly signed by her instrumental witnesses at the spaces herein provided which they acknowledged to me as their free and voluntary act and deed. WITNESS MY HAND AND SEAL, this _____ day of __________ 2018, in ________________.

Doc. No. ________ Page No. ________ Book No. ________ Series of 2018