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Republic of the Philippines )

City of ________________ ) S.S.

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _____name of the client/owner___________________, of legal age, with office address at


_____________________________, do hereby APPOINT,
______________________Filipino, single, likewise of legal age. with office address at
___________________________and to perform the following acts:

a. To transact and represent me before the Food and Drug Administration (FDA), to
(additional task) sign, transact and execute the business closure of my company.

b. To sign, deliver any document or written instrument, transact, facilitate, pay the
necessary fees for the said transactions;

c. Other analogous transactions pertinent to my business not limited to business


registration to the appropriate government agency.

d. To do and perform all and every act and thing whatsoever requisite or necessary to be
done in and about the premises and hereby ratifying and confirming all that the
aforementioned names shall lawfully do or cause to be done by virtue of this
authorization.

IN WITNESS WHEREOF, we have hereunto set our hands this _____________day of


__________, 2020 ___________.

Name of the client/owner


Principal
Accepted by:

JOHN DENIEL D.C. REMENTINA


Attorney-in-fact
ACKNOWLEDGMENT

Republic of the Philippines)


City of _______________ ) S.S.

BEFORE ME, a Notary Public, for and in ______________City, this _______ day of
_________________________ personally appeared:

         Name                          Identification Card       Issued On/At

(Name of the client) Philippines__


________________________ Philippines__
____ ______ Philippines__
__________________________ ___ Philippines__

all known to me to be the same persons who executed the foregoing instrument consisting of


2 page/s, including this page on which this acknowledgment is written, and who
acknowledged to me that the same is their free and voluntary act and deed.

 WITNESS MY HAND AND NOTARIAL SEAL.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2020:

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