SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
We, SPOUSES ______________________, both of legal ages, Filipinos and residents of
Quezon City, Philippines, do hereby name, constitute, and appoint, ________________, of legal
age, Filipino, married and a resident of Quezon City, Philippines, to be our true and lawful
ATTORNEY-IN-FACT, for us and in our names, places and steads, to do and perform the
following specific acts, to wit:
1. To attend and represent us during the mediation proceedings of the CIVIL CASE NO.
_________________ (For _________________) before the Philippine Mediation Center, Hall
of Justice, Quezon City on our behalves as the Defendants therein on April 20, 2024 at 10:00
o’clock in the morning, in view of our inability to so attend thereat due to being indisposed because
of health reasons.
2. To agree to an amicable settlement or to submit to any of the alternative modes of dispute
resolution of said case, under such terms and conditions as our attorney-in-fact may deem proper.
3. To simplify the issues of the cases; to enter into stipulations or admissions of facts and
documents with the Plaintiff, whenever warranted.
4. To do and agree on such other matter as may aid in the prompt disposition of the above-
entitled case.
5. To sign, receive and provide any document in our behalves regarding the above-
mentioned case and do whatever is necessary in order to implement this special power of attorney.
AND HEREBY GIVING AND GRANTING unto our said Attorney-In-Fact full power and authority to do
and perform any and every act requisite or necessary to carry into effect the foregoing authority, as fully to all intents
and purposes as we might or could lawfully do if personally present, and hereby ratifying and confirming all that our
said Attorney-In-Fact shall lawfully do or cause to be done under and by virtue of these presents.
IN WITNESS WHEREOF, we have hereunto set our hands on this ___________, at Quezon City,
Philippines.
_______________________ ______________________
Principal Principal
ID: ID:
SIGNED IN THE PRESENCE OF:
___________________________ __________________________
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
QUEZON CITY ) S.S.
BEFORE ME, a Notary Public for and in the above just stated jurisdiction, on this
______________, personally appeared ________________________________, exhibiting their competent
proofs of identity as indicated above just below their respective names showing their photos and signatures
with which I ascertained their true persons, known to me 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 NOTARIAL SEAL, the date and place above written.