SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, [Insert Name], Filipino, of legal age, [Insert Civil Status], and resident of
[Insert Address], do hereby name, constitute and appoint, [Insert Name of Attorney-in-
Fact], Filipino, of legal age, [Insert Civil Status], and with residence and postal address at
[Insert Address], as my true and lawful Attorney-in-Fact, for me and in my name, place
and stead, to do and execute the following acts or things, to wit:

[Insert purpose of SPA and reason for appointing an Attorney-in-Fact].

HEREBY GIVING AND GRANTING unto my Attorney-in-Fact the full power

and authority to do and perform all acts, as fully to all intent and purposes as I might
add or could do if personally present hereby ratifying and confirming all previous
transactions of all kinds and all that my said Attorney-in-Fact shall lawfully do or cause
to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hands this ___ day of _________ 20__,
in the city of _________________.

_________________________________ _________________________________
[Insert Name] [Insert Name of Attorney in Fact]

1
 ACKNOWLEDGMENT

Republic of the Philippines)

__________________________)S.S.

Before me, a Notary Public for and in the City of ___________, this _______ day
of _________ 2019 personally came and appeared:

Known to me to be the same person who executed the foregoing Special Power of
Attorney, and acknowledged to me the same is his/her free and voluntary act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on
the date and at the place above written.

NOTARY PUBLIC
Doc. No. ______ ;
Page No. ______ ;
Book No. ______ ;
Series of 20__.