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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ___________________________________________, of legal age,


Filipino, single, with permanent address at
___________________________________________, have NAMED, APPOINTED
and CONSTITUTED, ____________________________________________,
likewise of legal age, Filipino and presently residing at
________________________________________, as my true and lawful
ATTORNEY-IN-FACT, for me and in my name, place and stead, for my own use
and benefit, to do any or all of the following acts and things to wit:

1. To designate, hire and/or appoint attorney-at-law to protect my


rights and interest related to his power stated herein; and

2. To sign, execute, receive and/or deliver contracts and agreements,


other papers and/or money to effect with his power stated in this
authorization pertinent to the above described authority.

HEREBY GIVING AND GRANTING unto said Attorney-in-fact, full power


and authority to perform each and every act and thing whatsoever requisite or
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 acting, and hereby ratifying and
confirming all that my said Attorney-in-fact shall lawfully do or cause to be done
under by virtue of these presents.

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


_____________ at the Consular Section of the Philippine Embassy in
_______________________.

Principal
(Name and Signature)

(Attorney-in-fact)

SIGNED IN THE PRESENCE OF:

1. _________________________ 2. _________________________
Witness Witness
Name and Signature Name and Signature

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