SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, [NAME], Filipino, of legal age, with address at [address] do by these presents

hereby CONSTITUTE AND APPOINT [REPRESENTATIVE] to be my true and lawful
Attorney/s-in-Fact to represent me before the Bureau of Internal Revenue (BIR) and the
appropriate Local Government Units (LGUs) in securing all the necessary permits, licenses,
and other documents required for the lawful operation of [COMPANY], a [type of company]
registered with the [SEC/DTI (include details)] with principal office located at [company
address] and of which I am [POSITION].

HEREBY GIVING AND GRANTING unto my said Attorney/s-in-Fact full powers

and authority to do and perform all and every act requisite or necessary to carry into effect
the foregoing authority, including full authority to sign, execute, deliver and claim
documents, agreements and other writings of whatsoever nature, kind and description and
other legal papers pertaining thereto, as fully to all intents and purposes as I might or could
lawfully do if personally present, and hereby ratifying and confirming all that our said
Attorney/s-in-Fact shall lawfully do or cause to be done by virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hands this

____________________ in ____________________, Philippines.

[NAME]
Principal

Signed in the presence of:

____________________________________ ___________________________________

SUBSCRIBED AND SWORN to before me this ________________________, at

________________________ affiant exhibiting to me his/her competent evidence of identity
as follows: ___________________________________________.

Notary Public

Doc No.: ______

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