SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _____________________, of legal age, Filipino, and a resident of Caramcam, Mangagoy,

Bislig City, Surigao del Sur, do hereby constitute and appoint and does by these presents MAKE,
CONSTITUTE AND APPOINT , _____________________, of legal age and a resident of
Bislig City, Philippines, to be the TRUE AND LAWFUL ATTORNEY- IN-FACT for
me and my name, place and stead, and for my own use and benefit, to do and perform all or any
of the following act:

 To represent the City Organic Agri-Fishery Tourism Complex (COAFTC) for

the processing of the application for accreditation and other related documents
regarding farm tourism to the Department of Tourism and will serve as the
official point person of the aforesaid enterprise.
 To facilitate and perform all the necessary transactions that are related to
COAFTC Farm Tourism.

HEREBY GIVING AND GRANTING unto said attorney-in-fact full power and authority
to do and perform all and every act and thing whatsoever requisite, and necessary to be done, in
about the premises, hereby ratifying and confirming all that said attorney-in-fact shall lawfully do
or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of

_______________ at Bislig City, Surigao del Sur, Philippines.

_____________________Principal
Conforme:

_____________________
Attorney-in-Fact

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

BISLIG CITY ) S.S.

BEFORE ME, this ____ day of ______________________ at the City of Bislig, appeared:

Name ID Type ID No.

known to me to be the same persons who personally signed the foregoing Special Power of Attorney and
they acknowledged that the same is their free act and deed.

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

Doc. No. _____;

Page No. ____;
Book No. ____;
Series of 2021.