SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS

I, (INSERT NAME HERE) of legal age, a citizen of Philippines, and resident of (INSERT
RESIDENTIAL ADDRESS HERE), sole proprietor of (INSERT BUSINESS NAME HERE) with TIN XXX – XXX –
XXX - XXX represented by (INSERT NAME HERE) to be my true and lawful attorney-in-fact, for me and my
name, place and stead, to do perform the following acts and deeds:

1. To facilitate to process, apply for, and represent us in the Bureau of Internal Revenue RDO
___ and Revenue Region Office.
2. To execute, sign, file, deliver and submit forms, documents and instruments related to the
above declared;
3. To delegate the whole or in part any of all powers therein granted or conferred, by means of
an instrument in Writing, in favor of any third person or persons whom our said attorney
may select;

HEREBY GIVING AND GRANTING unto said our attorney-in-fact, full power and authority
whatsoever requisite or necessary or proper to be done in and about the premises as fully to all intents
and purposes as we might or could lawfully do if personally present, and hereby ratifying and confirming
all that said attorney shall lawfully do or cause to be done under and by virtue of these presents.

______________,
Principal

____________________
Attorney-in-fact

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES)

BEFORE ME, this ___ day of ______, 2020 at _____________________ personally came and
appeared showing competent and proof of identity, known to me to be the same persons who executed
the foregoing instrument and acknowledge to me as their free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and place first above written.

Doc. No. ____________

Page No. ____________
Book No. ___________
Series of: ____________