SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _____________________, of legal age, with residence at _____________________, do

hereby NAME, APPOINT and CONSTITUTE, _____________________, of legal age,
Filipino, with office at _____________________, to be my true and lawful attorneys
to act in, manage and conduct all my affairs, and for that purpose in my name
and in my behalf to do and execute all of any of the following acts, deeds and
things, to wit:

1. To receive and collect from the Social Security System any and all
sums of money/checks which I may claim as funeral benefits
arising from the death of my husband, _____________________;

2. To represent, execute, pay the fees required, sign any and all
document(s) and paper(s) as well as claim/receive for and in my
behalf said document(s) from the Social Security System as well as
to do any and all acts in order to accomplish the aforestated acts
and deeds.

My attorney-in fact hereby accepts this appointment subject to its terms and
agrees to act and perform in said fiduciary capacity consistent with my best
interest as they in their best discretion deems advisable, and I affirm and ratify
all acts so undertaken.

GIVING AND GRANTING unto 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, hereby ratifying and confirming all that
said attorney-in-fact shall lawfully do or cause to be done by virtue of these
presents.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___day of

August, 2013 at __________________________.

______________________________
Principal

With my conformity:

_____________________
Attorney-in-fact

Signed in the presence of:

______________________________ _________________________
 2

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

________________________ )S.S.

BEFORE ME, a Notary Public for and in the _____________ of

_______________, this ____ day of August , 2013, personally appeared:

GOVERNMENT DATE AND

NAME ISSUED ID PLACE ISSUED

All known to me and to me known to be the same person who executed

the foregoing Special Power of Attorney and he acknowledged to me that the same
is his free and voluntary act and deed.

This Special Power of Attorney consists of two (2) pages, including this
page whereon this acknowledgment is written.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my

notarial seal on the place and date first above-written.

NOTARY PUBLIC

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2013.