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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ________________ years old, Filipino, married and a resident of


_________________________ do hereby name, constitute and appoint
________________________, of legal age, Filipino, married and a resident
of __________________________, to be my lawful attorney-in-fact for me
and in my name, place and stead to do and perform the following acts and
things:

1. To bring suit, prosecute and/or file all appropriate actions (whether


civil, criminal or administrative case) in my behalf against
___________________, both of legal age, Filipino citizens, and residents
of San Vicente Ogbon and La Opinion, respectively, both at Nabua,
Camarines Sur, concerning the damage sustained by my
___________________________________ plus the recovery of damages,
and attorneys fees;

2. To sign and execute proper complaint, petition, affidavit including


Verification and Certification of Non-Forum Shopping related to the filing of
every pleading, petition, memorandum, motion or position paper before any
court of law or government agencies, as well as to sign and interpose
appeal, petition for certiorari or appeal memorandum whenever necessary;

3. To enter into compromise agreement and/or amicable settlement in


my name and stead, attend pre-trial conference, submit to alternative
modes of dispute resolution, and enter into stipulations or admissions of
facts and of documents, in connection with and related to my aforesaid
action/s brought or to be filed for or against me concerning the same
subject matter, with full authority to delegate this power to another person
or attorney who will attend to the case;

4. To designate, hire and/or appoint attorney-at-law to protect my


rights and interest related to his power stated herein;

5. To sign, execute, receive and/or deliver contracts and agreements,


other papers and/or money to effect with his power stated in this
authorization pertinent to the above described authority;

6. To do and perform any and all acts necessary for the faithful
execution of the foregoing acts and deeds.

HEREBY GIVING AND GRANTING unto my said attorney in fact full


power and authority to do and perform all and 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 and hereby ratifying and confirming all that my said attorney in fact
shall lawfully do or cause to be done by virtue thereof.

IN WITNESS WHEREOF, I have hereunto set my hand this


______________ 2017.

__________________
Principal
Conforme:

______________________
Attorney-in- Fact

_____________________ witnesses ____________________

ACKNOWLEDGMENT