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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _________________________, of legal age, married, Filipino and resident of Barangay


Calumpang, Milagros, Masbate, do hereby NAME, CONSTITUTE and APPOINT EPIFANIO T.
BERNAL, JR., of legal age, married, Filipino and a resident of Barangay Calumpang, Milagros, Masbate,
to be my true and lawful attorney-in fact, for me and in my name, place and stead, to encash my check
with check no. _______ amounting to five thousand pesos only (₱5,000.00).

HEREBY GIVING and GRANTING unto my said attorney-in fact full powers and authority to do
and perform all and every act requisite or necessary to carry into effect the foregoing authority to encash,
as fully to all intents and purposes as I might or could lawfully do if personally present and acting in person;
and HEREBY RATIFYING and CONFIRMING all that my said attorney-in fact shall lawfully do or cause
to be done by virtue hereof.

IN WITNESS WHEREOF, we have hereunto set my hand this _____ day of ____________, 2018
at Masbate City, Masbate, Philippines.

_________________________ EPIFANIO T. BERNAL, JR.


Principal Attorney-in Fact

SIGNED IN THE PRESENCE OF:

____________________________ _____________________________
Witness Witness

ACKNOWLEDGEDGEMENT

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF MASBATE )S.S
CITY OF MASBATE )
X--------------------------X

BEFORE ME, this 15th day of August, 2018 at Masbate City, Masbate, Philippines personally
appeared:

Name CTC No. Issued on Issued at


EPIFANIO T. BERNAL, JR. Brgy. Calumpang, Milagros, Masbate
Brgy. Calumpang, Milagros, Masbate

known to me to be the same person who executed the foregoing instrument, and acknowledged that the
same are their own free act and deed.

IN WITHNESS WHEREOF, I have hereunto set my hand and affixed my notarial seal on the date
and place above written.

Doc. No. ____________;


Page No. ____________;
Book No. ____________;
Series of 2018

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