SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

THAT I, _________, of legal age, Filipino, married and a resident of

________________________________________, have named, constituted and appointed and
by these presents, do hereby name, constitute and appoint ____________, of legal age, married,
Filipino, and a resident of ____________________________________, Philippines, to be my
true and lawful Attorney-in-Fact, for me and in my name, place and stead and for my own use
and benefit, to do and perform the following acts and deeds hereinafter mentioned:

1. To institute any action before any tribunal, agency, administrative body, quasi-judicial
body or court for but not limited to _________________________ in order to establish
my rights and interest;

2. To represent me in any tribunal, agency, administrative body, quasi-judicial body or court

relative to the said case(s) in all stages of the said proceedings; to enter into the
possibility of submission to arbitration or alternative modes of dispute resolution,
compromise or amicable settlement under such terms and condition which he may deem
proper and beneficial; the necessity or desirability or amendments to the pleadings; the
simplification of the issues; the possibility of obtaining stipulations or admissions of facts
and of documents to avoid unnecessary proof; the limitation of the number of witnesses
and such other matters as may aid in the prompt disposition of the action;

3. To testify and adduce evidence in my behalf and to submit and execute any and all
papers, documents, pleadings to be filed relative to the said case(s);

4. To submit, sign, execute or receive any and all papers or documents which may be
necessary or required in order to accomplish the purpose(s) above-mentioned and to
perform any and all acts for the accomplishment of the purposes mentioned in the
preceding paragraph;

HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and
authority to do and perform every act and thing whatsoever requisite and necessary to be done in
and about the premises, as fully to all intents and purposes as we might or could do if personally
present and;

HEREBY RATIFYING AND CONFIRMING all that my said Attorney-in-Fact shall

lawfully do or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ of

____________, 2018 at _________________________________________________.

_____________________________
Principal-Affiant
ACCEPTED:

___________________
Attorney-in-Fact

Signed in the Presence of:

___________________ ___________________

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 CKNOWLEDGMENT

Republic of the Philippines )

________________________ ) S. S.
x- - - - - - - - - - - - - - - - - - - - - - x

BEFORE ME, a Notary Public in ____________________, this ____th day of

__________, 2018 here at __________________, personally appeared ________________ and
____________ with their Proofs of Identities written below their respective names and
signatures, known to me and to me known to be the same persons who executed the foregoing
instrument consisting of two (2) pages including this Acknowledgement and acknowledged to
me that the same is their free and voluntary act and deed.

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

Doc. No.____;
Page No.____ ;
Book No.____ ;
Series of 201___

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