Professional Documents
Culture Documents
I, ROGER ESPINOSA RAYRAY, of legal age, Filipino, single and a resident of 14 Calvo Street,
Barangay Poblacion, Municipality of Dasol, Province of Pangasinan, Philippines, do hereby NAME,
CONSTITUTE, and APPOINT –
___________________________________________
Of legal age, Filipino, and resident of No. 2, 1 Mercury Avenue Extension, Barangay Pasong Tamo, Quezon
City, Philippines, to be my true and lawful Attorney in my name, place, and stead, to do the following:
2. To sign receipt thereof and pay any sum required for such documentary requests;
3. To institute and sign in my behalf the verification of records, filing, notifying and
application for SSS Member Pension with any office Social Security System;
4. To sign any other documents relative to the processing of my pension in any office
Social Security System;
5. To do or perform other acts or things found necessary in compliance with this authority.
HEREBY GIVING AND GRANTING unto my said attorney full powers and authority to do or perform
all acts of things requisite or necessary to carry into effect the foregoing authority, 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 attorneys or their substitute shall lawfully do or cause
to be done by virtue hereof.
IN WITNESS HEREOF, I have hereunto set our hands this _____________ in City of
Manila, Philippines.
ACKNOWLEDGMENT
BEFORE ME, Notary Public for and in the City of Manila, Philippines, this ___________ personally
appeared the party hereto named, known to me and to me known to be the same person who executed the
foregoing instrument and further acknowledged to me that the same is his free and voluntary act and deed.