SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENT:
I, [PRINCIPAL’S NAME], of legal age, Filipino citizen, with address at [PRINCIPAL’S
ADDRESS], do hereby name, constitute, and appoint [AGENT’S NAME], of legal age, Filipino
citizen, and with address at [AGENT’S ADDRESS], whose specimen signature appears below to be
my true and lawful attorney-in-fact:
To process, transact, receive, my [PURPOSE], and to execute any and all papers relating
thereto and to sign, execute, acknowledge and deliver any and all Documents other writings
therefor, or in any way connected therewith.
GIVING AND GRANTING unto my said attorney-in-fact full power and authority to do and
perform all and every act and thing whatsoever requisite and necessary to be done in and about the
premises, as fully to all intents and purposes as I might or could lawfully 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 ___ day of
________________.
[PRINCIPAL’S NAME]
(Principal)
[AGENT’S NAME]
(Attorney in - fact)
REPUBLIC OF THE PHILIPPINES)
CITY OF ) S.S.
ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in ________________, personally came and appeared
[PRINCIPAL’S NAME] with competent proof of identity known to me to be the same person who
executed the foregoing Special Power of Attorney, acknowledged to me that the same is his free and
voluntary act and deed.
WITNESSETH my hand and seal this ___ day of _________________, Philippines.
DOC. NO._______
PAGE NO.___
BOOK NO. 2023
[INSERT ID PHOTO OF PRINCIPAL WITH 3 SPECIMEN SIGNATURES AT THE BOTTOM]
[INSERT ID PHOTO OF AGENT WITH 3 SPECIMEN SIGNATURES AT THE BOTTOM]