SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ______________, a __________, ___________, with Passport No.

_____________ issued on ____________ and valid until ____________, do
hereby appoint and authorize ____________________, to be my true and lawful
attorney-in-fact for me and in my name, place and stead and to do and perform
the following acts:

a. To apply on my behalf for a _______________________;

b. To handle, execute, sign and deliver any and all applications,

documents, forms, instruments and papers, and transact and make
payments, that are necessary or useful to secure my __________; and

c. To do such other things and acts which maybe necessary for the
accomplishment and attainment of the aforementioned powers and
duties.

HEREBY GIVING AND GRANTING unto my representatives the full

power and authority to execute and perform every act necessary to render
effective the foregoing powers, as though I myself have so performed it, and
HEREBY APPROVING ALL that they mat do by virtue hereof with full right of
substitution of person and revocation of this instrument.

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

_________ ____, at _____________________.

___________________
Principal