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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THIS PRESENT:

That I, _________________, of legal age, Filipino, with residence and postal address
at ____________________________, do hereby NAME, CONSTITUTE AND
APPOINT ____________________, likewise of legal age, Filipino, with residence and
postal address at _____________________, to be my true and lawful Attorney-in-Fact,
for me and in my name, place and stead to do and perform all of any of the following:

1. To represent me for and in my behalf in TRANSACTING WITH THE


LANDBANK OF THE PHILIPPINES – CLAVER;

2. To process the release of, and claim, my ATM Card that got stuck in the ATM
machine;

3. To represent, execute, pay the fees required, sign any and all document(s) and
paper(s) as well as claim/receive for and in my behalf said document(s) from
LANDBANK, as well as to do any and all acts in order to accomplish the
afore-stated acts and deeds.

4. GIVING AND GRANTING unto the said ATTORNEY-IN-FACT full power


and authority to do and perform all and every act and deed whatsoever
requisite and necessary to be done in and about the premises, as fully as to all
intents and purposes as I may could lawfully do if personally present with all
the power of substitution or revocation and hereby RATIFYING and
CONFIRMING all that my ATTORNEY-IN-FACT or his substitute can
lawfully do or cause to be done by virtue thereof.

IN WITNESS WHEREOF, I have hereunto affix my signature this 12th day of


November.

__________________________
PRINCIPAL

________________________
ATTORNEY-IN-FACT

SIGNED IN THE PRESENCE OF:

_____________________________ _____________________________
Witness Witness

ACKNOWLEDGMENT

Republic of the Philippines )

1
Province of Surigao Del Norte) SS.

BEFORE ME, a Notary Public for and in the above jurisdiction, personally
appeared this____ day of ______________, 2024.

NAME I.D. # DATE/PLACE ISSUE

___________________ _____________________ _____________________


___________________ _____________________ _____________________

known to me to be the same persons who executed the foregoing instrument and each of
the acknowledge to me that the same is his/her own free and voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL, on the date and at the place
first above written.

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