SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I/We __________________________________, of legal age, Filipino citizen,

(married/single) and residing at _____________________________________________, do hereby
name, appoint, and constitute _______________________________________________, likewise of
legal age, Filipino, and residing at ________________________________________________________
my/our true and lawful attorney-in-fact and in my/our name, place and stead and behalf, to do the
following act(s):

1. To receive for and in our behalf from RCBC Savings Bank original collateral documents
and other papers pertaining to my fully paid AUTO loan.
Loan details:
Loan# _____________________
Model ______________________
Motor#______________________
Chassis# ____________________

2. To sign any deed or document in acknowledgment of the receipt thereof;

3. To do and perform any acts necessary to accomplish the purpose above mentioned.

I / We hereby release, remise and forever discharge RCBC SAVINGS BANK, its stockholders,
officers, directors and employees and defend it/them from any actions, damages, claims and demands
arising wholly and partially in connection with the above letter of authority.

I / We further signify that I / We will not file or cause to be filed any case or legal action or
proceeding against the Bank or the above persons and entity.

HEREBY GIVING and GRANTING unto said Attorney-in-Fact full power and authority to do and
perform every act and thing whatsoever requisite and necessary to be done in and about the premises,
as fully to all intents and purpose as I/we might or could do if personally present, HEREBY RATIFYING
and CONFIRMING all that my/our said Attorney-in-Fact shall lawfully do or cause to be done under the
premise.
IN WITNESS WHEREOF, I/We have hereunto affixed my signature this ___________________,
at _________________________.

Specimen signature of :
BORROWER(s) Attorney-in-fact
(Authorized Representative)

__ _____________________ _________________________ __ _______________________

Signature over printed name Signature over printed name

Signed in the presence of:

___________________________ ____________________________

ACKNOWLEDGMENT
Republic of the Philippines)
____________ ________City) S.S.
I certify that on this date, before me, a notary public duly authorized in the city named above to
take acknowledgements, personally appeared:
NAME COMPETENT EVIDENCE OF DATE AND PLACE ISSUED
IDENTITY

who was/were identified by me through competent evidence of identity to be the same person/s
described in the foregoing instrument, who acknowledged before me that his/her/their respective
signatures on the instrument was/were voluntarily affixed by him/her/them for the purposes stated
therein, and who declared to me that he/she/they have executed the instrument as his/her/their free and
voluntary act and deed.

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

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