CLASS C

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I/we,____________________________, of legal age, married, Filipino, and currently residing

of__________________________________ do hereby name, constitute and appoint,_____________________ of legal age, Filipino, and a resident
___________________________, to be my true and lawful attorney-in-fact, for me and in my name, place, and stead, to do and perform the following
special power wit:

1. To get/receive from the Landbank of the Philippines the Certificate of Full payment an Release of Real Estate Mortgage covered by
CLOA/EP______________________________ identified for Lot No._______________________________ containing an area
of_____________________square meters situated in ______________________________________and registered in the name of
________________________________;

2. To sign for, execute and deliver any all paper or document necessary to give effect to the foregoing Power of Attorney;

3. To sign for, executive Data Privacy Consent Form on behalf of the Principal and he/she is authorize to disclose personal date or
sensitive personal information of the Principal.

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full powers and perform all and every act and thing whatsoever
requisite and necessary to be done in in and about the premises, as fully, to all intents and purposes, as I might or could do if personally present and
hereby ratifying band confirming all that my-said Attorney-in-Fact shall lawfully do or cause to be done by the virtue thereof.

I/we hereby undertake to be solely responsible for whatsoever dispute/ disagreement that may arise within the family or caused by other
interested party/ies as the regards the above -mentioned agricultural land in relation to the issuance/ release of CFP/ROREM.

I/we declare that the Land Bank and/ or its officials and employees shall no be held liable for any loss, damages, or injury, whether direct or
indirect, actual or consequential or otherwise, arising or resulting from this Special Power of Attorney, and we undertake to hold the Land Bank and/ or
its officials and employees free and harmless from any and liabilities and shall fully reimburse Land Bank and/or its officials and employees against any
and all claims and suits for loss, damage or injury by any third persons/s arising/resulting from this Special Power of Attorney and release of
CFP/ROREM

IN WITNESS WHEREOF, we have hereunto set our hands on this ___ day of _____________________, at_______________________.

Conforme:

_______________________________________ ___________________________________________
Principal Attorney-in-Fact

SIGNED IN THE PRESENCE OF:

_______________________________________ ____________________________________________
Witness Witness
Republic of the Philippines…..)
Capas, Tarlac …………….) S. S.

ACKNOWLEDGMENT

BEFORE ME, a notary public for the City/Municipality of _____________________, on this day of, ____________________, personally
appeared:

Name Competent Evidence of Identity Place and Date of Issue

______________________________ ____________________________________ ___________________________________
______________________________ ____________________________________ ___________________________________
______________________________ ____________________________________ ___________________________________
______________________________ ____________________________________ ___________________________________

Known to me and to me known to be the same person/s who executed the foregoing instrument and acknowledged to me that the same is their free act
and deed.

Doc. No. ______; NOTARY PUBLIC

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