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Republic of the Philippines)

______________________ ) Sc.
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Special Power of Attorney

I, _______________________, of legal age, Filipino citizen and a resident of


___________________________, in my capacity as the owner of __________________, a sole
proprietorship, with business address at ___________________________, Bacolod City, Negros
Occidental authorize _______________________________ to represent the company to process,
transact, deal with Bureau of Internal Revenue (BIR) to request of the Company’s Certificate
of Registration; to claim and receive the release of the documents for our company; to sign
any papers, documents and instruments in pursuant or in connection therewith; and to do
such and other acts as may be necessary to effect and execute the above transaction.

IN WITNESS WHEREOF, I have here unto set my hand this _______ day of_______ at
Bacolod City, Philippines.

_______________________
AFFIANT

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the ___________________, personally appeared
_______________________, with TIN ____________, personally known to me (or whom I have
identified through competent evidence of identity) and who represented to me that his/her
signature on 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 his/her
free and voluntary act and deed.

WITNESS MY HAND AND SEAL this _____________ at _____________, Philippines.

NOTARY PUBLIC

Doc. No. ______;


Page No. ______;
Book No.______;
Series of 2018.

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