Republic of the Philippines )

Municipality of _________________) S.S.

SPECIAL POWER OF ATTORNEY

 KNOW ALL MEN BY THESE PRESENTS:

 
I, ___________________, single, of legal age, with postal address at
________________________________ do hereby APPOINT _______________, married, of legal age,
with postal address _______________________, my true and legal representative to act for and in my
name and stead and to perform the following acts:

 To transact, sign, claim, execute and deliver for me and in my name any legal document
or instrument necessary for the transfer of ownership of my car and carrying out into
effect the power and authority herein granted.

I do hereby grant my attorney-in-fact complete and full authority to act in any reasonable and
necessary manner for the purpose of exercising the above mentioned powers. I also, ratify all the
lawfully performed acts by my attorney-in-fact in exercising those powers.
 
IN WITNESS WHEREOF, we have hereunto set our hands this _________ day of
___________________ 2022 at __________________________________.
 

________________________ ____________________
Affiant Attorney-In-Fact

BEFORE ME, personally appeared:

            
Name Driver’s License No. Expiration Date
___________________ _______________ ______________
___________________ _______________ ______________ 

Known to me and to me known to be the same persons who executed the foregoing instrument and
acknowledged to me that the same is their free and voluntary act and deed.

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

                                                                                                              
Notary Public                     

Doc. No.______;
Page No. ______;
Book No.______;
Series of 2022.