REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF ___________) S.S.

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

We, KRISTEL S. MARINO and DIESECA B. ROMERO, all of legal

age, single/married/in common-law relationships, with residence and office
address at Brgy. ___________,________________, Northern Samar, do
hereby NAME, APPOINT, CONSTITUTE, AUTHORIZE, LYLE MONTALLANA
SIERVO, of legal age, Filipino, single/married/in common-law relationships,
resident of Brgy. _____________, ________________, Northern Samar,
Philippines as our true and legal representative to act for and in our name and
stead and to perform the following acts:

1. To process, claim, secure, received Service Recognition

Incentive (SRI) from DepED Northern Samar;

2. To sign the document related thereto; and

3. To do any act which carry this authority into effect.

HEREBY GRANTING unto our said Attorney-in-fact, full power and

authority to execute and perform every act necessary which may
necessary or convenient, in connection with any of the foregoing as fully to
all intents and purposes as though we, have so performed it, and HEREBY
APPROVING ALL that she/he may do by virtue hereof with full right
of substitution of his/her person until revocation of this instrument.

IN WITNESS WHEREOF, WE HAVE HEREUNTO SET OUR HANDS, this

____ day of _________________, at _____________, Northern Samar.

KRISTEL SIERVO MARINO DIESECA B. ROMERO

Principal Principal
Proof of Identity: ___________ Proof of Identity: ___________

With my conformity:

LYLE M. SIERVO
Attorney-in-Fact
Proof of Identity: __________________

BEFORE ME, personally appeared above-mentioned persons,

who exhibited to me competent proof of identity, known to me and to me
known to be the same persons who executed the foregoing instrument and
acknowledged to me that the same is their free and voluntary act and
deed.

WITNESS MY HAND AND SEAL,____this _________at

_____________Northern Samar.

Doc. No.______;

1|Page SPECIAL POWER OF ATTORNEY

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

2|Page SPECIAL POWER OF ATTORNEY