You are on page 1of 2

SPECIAL POWER OF ATTORNEY

I _______________________, hereby name, appoint and constitute


_________________________ to be my true and lawful attorney, to
act on my behalf and in my name, to execute and perform all or any
of the following acts, deeds, matters and things, in connection with
_________________________, to wit:
(ENUMERATE POWERS TO BE CONFERRED)
HEREBY GIVING AND GRANTING unto our said attorney full powers
and authority to do and perform all and every act requisite or
necessary to carry into effect the foregoing powers, as fully to all
intents and purposes as I might or could lawfully do if personally
present, with full 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 by virtue hereof.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of
_________ 2001, in __________________.

____
________________________
Conforme:
(Signature of Appointee)

Signed in the presence of:


__________________________ __________________________

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES)
MAKATI, METRO MANILA ) S.S.
BEFORE ME , a Notary Public for and in the __________, this
___________________, personally appeared the following:
Name CTC
No. Place Date

known to me and to me known to be the same person/s who


executed the foregoing General Power of Attorney consisting of __
pages including the page on which this Acknowledgment is written,
and who acknowledged to me that the same is their free and
voluntary act and deed.
IN WITNESS WHEREOF, I have placed my hand and seal on the
date and at the place first above-written.

Doc. No.:
Page No.:
Book No.:
Series of _____.

You might also like