SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

THAT I, ___________________, of legal age, a Filipino citizen, with residence at

__________________________, have made, constituted, and appointed
_________________________, also of legal age, Filipino with residence at
______________________________, to be my true and lawful attorney to act in
my name and on my behalf and execute any or all of the following acts, deeds, and
things, to wit:

1. To process the authentication of my ____________________ issued by

the _______________________ before the Office of the
_________________________;

2. To process, sign, and execute any and all papers/documents with all and
any third persons, offices, concerns and entities in connection with the
above-given powers;

3. To do and perform for my behalf acts which are related to the above
powers.

HEREBY GIVING AND GRANTING unto my 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, as fully, to all intents and purposes,
as I might or could do if personally present and hereby ratifying and confirming all
that my said attorney in fact shall lawfully do or cause to be done by virtue thereof.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of

______________ 20___.

_____________________
Principal

Conforme:

_____________________
Attorney-in-fact

SIGNED IN THE PRESENCE OF

________________________ ________________________

ACKNOWLEGMENT

REPUBLIC OF THE PHILIPPINES)

CITY OF BACOLOD) SS.

BEFORE ME A NOTARY PUBLIC for and in the above jurisdiction personally

appeared ________________________ and _______________________ known to
me to be the same person who executed the foregoing instrument which he
acknowledged to be their free act and deed.

DOC. NO. _____;

PAGE NO. _____;
BOOK NO. _____;
Series of _____.