SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, _______________, of legal age, married, Filipino Citizen, and a resident of
Brgy. Villaerde, Iligan City, do hereby appoint, name and constitute, _________, of legal
age, married, Filipino citizen, and a resident of _______________, to be my true and lawful
attorney-in-fact in my place and stead, to do and perform any and all the following acts and
deed to wit:

1. To process and follow-up my Amendatory Permit and Occupancy Permit for a 4-

Storey commercial building located at ___________.
2. To follow-up my Application for Separate Account of meter with the ______Light
and Power Incorporated.

HEREBY GIVING AND GRANTING unto my said Attorney-in fact, full powers and
authority whatsoever requisite or proper and necessary to be done, authority in or about the
premises as fully all intents and purposes as I might or could lawfully do, if personally
present, with power or his substitute shall lawfully or cause to be done by virtue of these
presents.

IN WITNESS WHEROF, I have set my hands this 17th day of_____, 2020 at ____
City.

__________________
Principal

SIGNED IN THE PRESENCE OF:

1. ____________________________ 2. _______________________________

REPUBLIC OF THE PHILIPPINES)

CITY OF __________ …………………,)

BEFORE ME, this 17th day of March, 2020 at ____City, personally appeared
_________with CTC No . _____________ known to me to be the same person who executed
the foregoing instrument and acknowledge to me that the same is his free and voluntary act
and deed.

WITNESS MY HAND AND SEAL, this 17 th day of _____2020 at ____ City,

Philippines.

Doc No, ___________

Page No. __________
Book No.__________
Series of 2020