SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ___________________________________________________________, Filipino citizen/s of legal
age, single/married, with residence and postal address at ____________________________________________ do
hereby name, constituted, and appointed and by these presents do hereby name,, constituted and appoint
_____________________ likewise of legal age, single/married/widow and with postal address at
______________________________________ to be my own and lawful Attorney-in-Fact, for me and in my name,
place and stead, to do and perform any and all of the foregoing acts and things, namely:

HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and authority to do and perform any and
every act thing whatsoever required and necessary to be done as I might or could do, I personally present and acting
in person, 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 signed my name this _______ day of _________, 20___
at______________________________. _____________________________

_____________________________
Signature

_________________________________ With marital consent

Specimen Signature of Attorney-in-Fact ______________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

PROVINCE/CITY OF ____________) S.S.

BEFORE ME, A Notary Public for and in the _______________________, Province of

_____________________, this ______ day of _____________, 20______, personally appeared the above-named
persons, who has satisfactorily proven to me their identity through their identifying documents written below their
name and signature, that they are the same person who executed and voluntarily signed the foregoing Special Power
of Attorney, which he/she acknowledged before me as his/her free and voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL.

NOTARY PUBLIC

Doc. No. _________;

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