SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
I, _________________, of legal age, Filipino, married, and a resident of
______________________________, do hereby APPOINT _________________________, of
legal age, Filipino, single, residing at _______________________________________, as my
true and legal representative to act for and in my name and stead and to perform the following
act, to wit:
1. To process, make representations, deal, and
_______________________________;
2. To fill out and sign, on my behalf, any forms, documents, or papers necessary
for the completion of the aforementioned purpose;
3. To perform, on my behalf, all other acts necessary to achieve the aforesaid
purpose and all other acts requiring my presence;
4. To perform, on my behalf, all other legal transactions requiring my presence,
in connection with the said purpose
HEREBY GIVING AND GRANTING unto my representative full powers and authority
to do and perform all and every act requisite or necessary to carry into effect the foregoing
powers, as fully to all intents and purposes as I might or could lawfully do if personally present,
with full power of substitution and revocation, and hereby ratifying and confirming all that my
representative shall lawfully do or cause to be done by virtue hereof.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___________ 2025
at Butuan City, Philippines.
______________________________
Affiant
____________________ ID No.: ________________
With my conformity:
____________________________
Attorney-in-fact
________ID No.: ______________________________
Signed in the presence of:
_________________ ____________________
Republic of the Philippines )
CITY OF BUTUAN…...) S.S
X=================================/
ACKNOWLEDGEMENT
BEFORE ME, a Notary Public for and in the City Of Butuan this_______________
personally appeared the following:
NAME COMPETENT EVIDENCE OF
IDENTITY
Who presented/exhibited to me competent evidence of identity as written opposite their
names and after carefully examining the same, I hereby attest that they are known to me and to
me know to be the same persons who executed the foregoing instrument and acknowledged to
me that such is of their own free will and voluntary act and deed.
The foregoing instrument is a Special Power of Attorney consisting of the two (2) pages
including this page on which the Acknowledgement is written and where the impressions of my
Notarial Seal and Signature are here under affixed. Each and every preceding page here of was
read and duly signed by the above-mentioned parties and their instrument witnesses.
Doc. No. :___________;
Page No.:___________;
Book No. :__________;
Series of 2025
