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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ___________________, Filipino, of legal age and a resident of


___________________ do by these presents hereby constitute and appoint
____________________________ to be my true and lawful Attorneys-in-Fact to represent
me before the _________________ to secure and file all the necessary documents for income
tax for other income.

HEREBY GIVING AND GRANTING unto my said Attorneys-in-Fact full powers


and authority to do and perform all and every act requisite or necessary to carry into effect
the foregoing authority, including full authority to sign, execute, deliver and claim
documents, agreements and other writings of whatsoever nature, kind and description and
other legal papers pertaining thereto, as fully to all intents and purposes as I might or could
lawfully do if personally present, and hereby ratifying and confirming all that our said
Attorneys-in-Fact shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hands this ___________ day of


_____________ 2020 in ___________________City, Philippines.

________________________________
Principal

Signed in the presence of:

____________________________________ ___________________________________

ACKNOWLEDGMENT
Republic of the Philippines)
________________City ) S.S.
x-----------------------------------/

BEFORE ME, a Notary Public for and in the City of _________________,


Philippines, this ___________________, personally appeared with _______________ issued
on __________ at _________ known to me and to me known to be the same person who
executed the foregoing instrument, acknowledged to me to be her free and voluntary act and
deed, consisting only of 1 page, including this Acknowledgment is written, duly signed by
her and her instrumental witnesses.

IN WITNESS WHEREOF, I have hereunto set my hand and seal this _____day of
_______________ in _____________________________, Philippines.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of ___.

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