SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _____________________________, Filipino, of legal age, and with address at

________________________________________, do hereby appoint ________________________,
Filipino, of legal age with address at _____________________________, as my true and lawful
representative to act for and in my name and stead and to perform the following acts:

1. To represent, process, submit, and secure the change of address for the
business of ___________________________ before the Bureau of Internal Revenue
RDO ______, as well as to secure authority to print and process the printing of Official
Receipts.

2. To process and apply for Business Permits before the pertinent Local
Government Units and offices.

3. To do and perform all and every act and things which may be necessary
or proper to carry out the above purpose.

HEREBY GRANTING unto my representative full power and authority whatsoever required or
necessary or proper to be done in and about the premises, and fully to all intents and purposes as I might
or could lawfully do if personally present, ratifying and confirming all that my said representative shall
lawfully do or cause to be done and by virtue of these presents.

IN WITNESS WHEREOF, I hereunto affix my signature this _______________ in

__________________, Philippines.

________________________ ___________________
Principal Agent

Signed in the presence of:

__________________________ ____________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES }

IN THE CITY OF ______________ } S.S
x--------------------------------------------x

BEFORE ME, a Notary Public for and in the City of _______________ on this ____ day of
_______________, personally appeared:

Name Competent Evidence of Identity Place Issued/Expiry

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

This instrument relates to a special power of attorney, and consists of one (1) page including this
page on which the acknowledgment is written, signed by the Parties and their witnesses and sealed with
my notarial seal.

WITNESS MY HAND AND SEAL this _____ day of _______________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 20__.