SPECIAL POWER OF ATTORNEY

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

BISLIG CITY ) S.S.

BEFORE ME, this 8th day of June 2021 at the City of Bislig, Philippines, appeared:

Name ID Type ID No.

PAG-IBIG
PHILHEALTH

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.

KNOW ALL MEN BY THESE PRESENTS:

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 8th day of June 2021
at Bislig City, Philippines.

I, _____________________, of legal age, Filipino, and a resident of Purok 6A, San

Fernando, Bislig City, Philippines do hereby constitute and appoint and does by these presents
MAKE, CONSTITUTE AND APPOINT , _____________________, of legal age and a
resident of Purok 6A, San Fernando, 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 transact and receive any benefits that I am entitled to claim from PAG-IBIG.

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 8th day of June 2021
at Bislig City, Philippines.

Principal
Conforme:
Attorney-in-Fact

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES)
BISLIG CITY ) S.S.

BEFORE ME, this 8th day of June 2021 at the City of Bislig, Philippines, appeared:

Name ID Type ID No.

PAG-IBIG
PHILHEALTH

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. 185;

Page No. 37;
Book No. II;
Series of 2021.