You are on page 1of 1

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, GRACEL GINIA REFERENTE LEGASPI, of legal age, Filipino citizen, single and with residence and
postal address at 231 Kennon Road, Poliwes, Baguio City, Philippines do hereby NAME, CONSTITUTE and
APPOINT, MS. KIRSTIE YANA RAFAEL residing at Building 306 Hamadbin Khalifa, Medical City, Doha, Qatar
to be my true and lawful Attorney-in-Fact for me and in my name, place and stead, to do and perform any and
all of the foregoing acts and things, namely;

1. To REQUEST AND CLAIM my POLICE CLEARANCE before the Minister of the Interior, Department of
Criminal Evidence and Information, located at Salwa Road Zone 55, Area No. 30, P.O. Box 23004 for the
purpose of my Immigration requirements in New Zealand;

2. To sign, and receipt for, execute and deliver any and all documents necessary and proper to effectuate
the aforementioned purpose;

HEREBY GIVING AND GRANTING, unto my said Attorney-in-Fact full power and authority whatsoever
requisite and necessary to carry into effect the foregoing authority for all intent and purposes as I might or
could do if personally present.

IN WITNESS WHEREOF, I have hereunto set my hand this 22nd day of June 2020 at Baguio City,
Philippines.

GRACEL GINIA LEGASPI


PRINCIPAL
Philippine Passport No.: P5188722B
Valid until May 19, 2030

_________________________________
KIRSTIE YANA ESTABILLO
Attorney-in-fact
Philippine Passport No.: P5572200A
Valid until January 10, 2028

SIGNED IN THE PRESENCE OF:

_______________________________________________ ______________________________________________

REPUBLIC OF THE PHILIPPINES )


CITY OF BAGUIO ) SS.
x----------------------------------------------x

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the City of Baguio, by the affiant who submitted that the foregoing instrument
was voluntarily affixed by her for the purposes stated in the instrument and who declared that she has executed the foregoing
instrument as her free and voluntary act and deed.

This Instrument consists of only one (1) page, including this page in which this acknowledgment is written, duly
signed by the affiant and her instrumental witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL this 22nd day of June 2020 at Baguio City, Philippines.

Doc No.:
Page No.:
Book No.:
Series of 2020.

You might also like