You are on page 1of 3

Exhibit 5


I, LUZ PUZON REYES, of legal age, widow, Filipino citizen and resident of (Street
address) do hereby constitute and appoint ANGELITO PUZON REYES, of legal age,
married, a resident of 287 Pag-asa, Kataasan, Dinalupihan Bataan, Philippines, to be my
true and lawful attorney-in-fact, for me and in my name, place and stead, to do and
perform the following acts and things, to wit:
1. To withdraw from my ATM Savings account No. 2631-0477-61 maintained with Land
Bank of the Philippines (LBP), particularly where my said account is maintained; OR
2. To encash my pension check/s at the Land Bank of the Philippines (LBP),
particularly where said account is maintained; and
3. To sign, execute and deliver any document or instrument and to perform such
other acts and deeds necessary to carry out the foregoing authority or power
herein conferred.
HEREBY GIVING AND GRANTING unto said attorney full power and authority to do and
perform any and every act and thing whatsoever requisite, necessary or proper to be
done in and about the premises 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 shall lawfully do or
cause to be done under and by virtue of these presents, subject to the following:

This Special Power of Attorney is valid and effective for a period of only sox (6)
months from the date of execution; and

In allowing my Attorney-in-Fact to withdraw in the manner above stated, I hold LBP

and any of its officers and employees free and harmless from any claim or liability
for any harm or damage that may arise as a consequence thereof.

IN WITNESS WHEREOF, I have hereunto set my hands this ______ day of October, 2016, in
San Diego, California.
Signature of Account Holder/Payee

Special Power of Attorney

OTC Withdrawal/Encashment of Check/s for Pensioner
Page 2
Signature over Printed Name of Witnessing Family Member
Signature over Printed Name of LBP Personnel
___________________________________ )
___________________________________ ) s.s.
At the above-stated locality, on this _______ day of October, 2016 before me personally
Philippine Passport Number _______________________________
Date and Place of Issue ____________________________________
Known to me and to me known to be the same person who signed the foregoing
instrument and acknowledged to me that the same is her free, voluntary act and deed.
This instrument consists of TWO (2) pages including this page whereon the
Acknowledgement is written and signed by the parties and witnesses on each and every
page hereof.
IN WITNESS WHEREOF, I have hereunto set my hand seal on the date and place first
above written.

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