SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, URSULA A. AQUINO, of legal age, widow, and a resident of Barangay San Carlos City,
Pangasinan 2420, do hereby appoint, name and constitute, VEDINNA EBBAH MOHAMMAD, of
legal age, married, and a resident of 1042 Sta. Rita Street, Malinta, Valenzuela City 1440, to be my true
and lawful attorney, for me and in my name and stead and to perform the following acts:

1. To process the filing of application for the late registration of my birth certificate in the
local Civil Registry of San Carlos City, Pangasinan, and;

2. To request, claim and receive the original copy of my birth certificate after its registration
from the local civil registry, Philippine Statistics Authority, (PSA), or appropriate
government agency.

HEREBY GIVING AND GRANTING unto our representative full power and authority to
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 shall
lawfully do or cause to be done and virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ________ 2020 at
___________ City.

URSULA A. AQUINO

With my conformity:

VEDINNA EBBAH MOHAMMAD

(Attorney-in-fact)

SIGNED IN THE PRESENCE OF:

____________________ ___________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

)SS.

BEFORE ME, on this _______day of 2020, personally appeared with competent evidence of
identity:

Name Gov’t Issued IDs Date/Place of Issue

URSULA A. AQUINO

VEDINNA EBBAH MOHAMMAD Postal ID PRN E67190505024 MLA,valid until 10/16/22

known to me and to me known to be the same person who executed the foregoing instrument and
acknowledged that the same is her free act and voluntary deed.

IN WITNESS WHEREOF, I hereunto set my hand and affixed my notarial seal on the date,
year and place above written.
Doc. No. _______
Page No. _______
Book No. _______
Series of 2020.