SPECIAL POWER OF ATTORNEY

KNOWN ALL MEN BY THESE PRESENTS:

That I, _______________, of legal age, married, Filipino Citizen, and resident of Brgy.
Palguyod, Pozorrubio Pangasinan, hereby NAME, CONSTITUTE and APPOINT
___________________of legal age, married, Filipino Citizen and resident of Brgy. Palguyod,
Pozorrubio Pangasinan as my true and lawful Attorney, for me and to my name, place and
stead, to do and perform the following acts;

1. To apply, process, procure, follow-up and receive any documents pertaining of

transfer of ownership of vehicle.
2. To represent me in the Land Transportation Office (LTO) in the transfer of
ownership of motor vehicle.

Make: MINI Serial No.: WMWSU1

Model No.: 16 COOPER BASE Motor No.: A1381761

Type: HATCHBACK Plate No.:

File: 1372-000

3. To, sign in my behalf any documents the LTO may require in the transfer of
ownership of motor vehicle.
4. To pay whatever fees and duties the LTO may impost in the transfer.
5. To do such any other act or thing that may be required necessary or incidental to
carry out effectively any all of the purposes for which this authority is hereby given.

HEREBY GIVING AND GRANTING unto our said Attorney-in-fact full power and
authority to do and perform any 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
lawfully do if personally present and hereby ratifying and confirming all that my said Attorney-
in-fact shall lawfully do or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, we have hereunto set our hands this ____ day of
___________________ at Binalonan, Pangasinan.

___________________________
PRINCIPAL
UMID I.D. No.: ___________
Issued by: SSS

SUBSCRIBE and SWORN before me this ____ day of ________________________ at

Binalonan, Pangasinan, by affiant who exhibited to me his I.D. No. as noted above.

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

NOTARY PUBLIC

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.