SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________, with residence and postal address at _____________________________

________________________________, do hereby APPOINT, CONSTITUTE, and DESIGNATE,
____________________ as my true and legal representatives to act for and in my name and stead
and to perform the following acts:

To cancel any document/s pertaining to my Tax Identification Number with the BIR
(Certificate of Registration BIR Form 2303;

To make, sign and execute, other writings of whatever nature or kind, with any and all
third persons, entities, or concerns, as well as RECEIVE, ACCEPT, and COLLECT, the
above-cited cancellation, upon terms and conditions acceptable to my said Attorney-In-
Fact;

HEREBY GIVING AND GRANTING unto my said attorneys full power and authority to do
and perform all and every act requisite or necessary to carry into effect the foregoing power, as
fully to all intents and purposes as I might or could lawfully do if personally present, with full
power of substitution and revocation, and hereby ratifying and confirming all that my said
agents/legal representatives shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ___________ 2022 in
___________ City.

________________________
Principal

________________________
Attorney-in-Fact

ACKNOWLEDGEMENT
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Republic of the Philippines )
City of ____________ ) S.S.

BEFORE ME, personally appeared:

Name Government ID Presented

__________________ _______________
__________________ _______________

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

This document consists of two (2) pages, including this page where the Acknowledgement is
written.

WITNESS MY HAND AND SEAL, this ____ day of ___________ 2022 in the City of _________.

Doc. No. ______;

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

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