SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________, Filipino citizen, of legal age, married, and a resident of

_________________________, do hereby NAME, APPOINT and CONSTITUTE my wife
_________________________, Filipino, of legal age, and a _____________________, to
be my true and lawful attorney-in–fact for me and in my name, to file and represent me in the
following cases against _______________, to wit:

1. To represent me in filing a Criminal Case for Reckless Imprudence Resulting in

Damage to Property before the Office of the City Prosecutor;

2. To represent me in filing an Administrative Case for Revocation of Driver’s License

with the Land Transportation Office;

3. To sign any document/s as may be required by the court or agency concerned;

4. To cause the preparation and filing of initiatory pleadings, Complaint, Complaint -

Affidavit, Reply/Answer, Counter-Affidavit, Motions, Position Paper, pleadings and other
related pleadings/documents in connection with the case/s;

5. To sign, execute or cause the execution of verifications, certificate of non-forum

shopping, affidavits, pleadings, Appeal Memorandum or Answer to Appeal, Motion to Dismiss,
Petition for Certiorari or Answer thereto, and in all other pleadings before the Land
Transportation Office, METC, MTC, MTCC, MCTC, RTC, Court of Appeals and the Supreme
Court or any courts of law, until the final termination of the cases;

6. To appear during the hearing, pre-trial, preliminary conference and all other subsequent
hearings as may be scheduled by the court or tribunal;

7. To enter into stipulations or admissions of facts and of documents, as may be deemed

and necessary.

a) The simplification of the issues;

b) The necessity or desirability of amendments to the pleadings;

c) The limitation of the number of witnesses;

d) The advisability of a preliminary reference of issues to a commissioner

e) The propriety of rendering judgment on the pleadings, or summary judgment, or of

dismissing the action should a valid ground therefore be found to exist;

f) The advisability or necessity of suspending the proceedings; and

g) To do any and all other acts necessary to consummate the authority given.

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full powers and authority to
do and perform every act and thing whatsoever requisites are necessary to be done in and about
the premises, as fully to all intents and purposes as I might or could do if personally present.

HEREBY RATIFYING AND CONFIRMING all that my said attorney-in-fact shall lawfully do or
cause to be done under and by virtue hereof.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______________ in

____________________________.

___________________________
Principal
 2

Signed in the presence of:

1. ______________________________ 2. ______________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

CITY OF . . . . . . . . . )S.S.
X - - - - - - - - - - - - - - - - - - - - - - -X

BEFORE ME a Notary Public for and in the City of __________________, this

_______________, personally appeared ____________________ who exhibited to me his
Professional Driver’s License No. _____________________, showing to me that he is the same
person who executed the foregoing special power of attorney which consists of two (2) pages
and acknowledged to me that the same is his own and free act and deed.

WITNESS MY HAND AND SEAL.

Doc. No. _______;

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