KNOW ALL MEN THESE PRESENTS: I, (Name of Principal), of legal age, single/married to (Name of spouse if any), Filipino, a resident of (Address), do hereby name, constitute, and appoint (Name of Agent /Attorney-InFact), to be my true and lawful attorney, for me and in my name, place, and stead, to do and perform the following acts and things to wit: To ask, demand, collect any and all sums of money, sue to recover debts, dues, accounts, dividends, legacies, bequests, interests , and other things of value of whatever nature or kind as may now be or may hereafter become due owing, payable or belonging to me, and to have, sue, and to take any all lawful ways and means for the recoverythereof by suit, attachment, compromise or otherwise; To make, sign, execute, and deliver contracts, agreements, documents and other writings of whatever nature or kind, with any and all third persons, entities or concerns, upon terms and conditions acceptable to my said attorney; To delegate in whole or in part any all of the powers herein granted or conferred, by means of an instrument in writing, favor of any third persons whom my said attorney may select; HEREBY GIVING AND GRANTING unto my said attorney full power and authority whatsoever requisite or necessary or proper to be done in and about the premises as fully to all intents and purposes as I might and could lawfully do if personally present, with 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 under and by virtue of these presents. IN WITNESS WHEREOF, We have hereunto affixed our signatures this ___________ day of ____________________ , 20__ in ______________________, Philippines.

___________________________________ (Principal)

__________________________________ (Agent /Attorney-In-Fact)

Signed in the presence of:



ACKNOWLEDGEMENT Republic of the Philippines) ) S.S

BEFORE ME, personally appeared: Name (Name of Principal) City (Name of Agent) City Known to me and to me known to be the same persons who executed the foregoing instrument and acknowledged to me that the same is their free and voluntary act and deed. WITNESS MY HAND AND SEAL, on the date and place first above written. Notary Public Doc. No.______; Page No. ______; Book No.______; Series of 20___. 10000000 January 28, 20__ / Mandaluyong CTC Number 10000000 Date/Place Issued February 24, 20__ / Paranaque