SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

WE, NAME OF PARENTS , both of legal age, Filipino, married, with

address at ADDRESS do by these presents hereby name, constitute and appoint
NAME OF COUSIN, likewise of legal age, Filipino, CIVIL STATUS, a resident of
ADDRESS OF COUSIN to be my true and lawful Attorney-in-Fact, for me and in
my name, place and stead, and for my own use and benefit, to do perform all or
any of the following acts and things, to wit:

1. To represent us before the Department of Foreign Affairs;

2. To have the Certificate of Live Birth of our Children, namely, NAME OF
CHILDREN duly authenticated;
3. To execute and sign any and all legal documents for accomplishment of
the aforementioned task;
4. To pay the necessary costs and expenses, if any, for the accomplishment
of the aforementioned task;

HEREBY GIVING AND GRANTING unto our 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 and about the premises, hereby ratifying
and confirming all that my said Attorney-in-fact shall lawfully do and cause to be
done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

______ of ____________, 2023 at Bacolod City, Philippines.

____________________________ ___________________________
Principal Principal

REPUBLIC OF THE PHILIPPINES )

) S.S.

ACKNOWLEDGMENT
As the afore-stated, this ___ day of ________________ 20__, appeared
before me with her corresponding Government Issued ID No.
NAME ID No.

to me to be the same person who executed the foregoing instrument and who

acknowledged to me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND NOTARIAL SEAL on the date and place first above-
written.

Doc. No. _________;

Page No. _________;
Book No. _________;
Series of 2023.