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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:


I,
address at

, Filipino, of legal age,


, with residence and postal
do hereby name, constitute and appoint
, Filipino, of legal age, single, with residence and postal address at
to be my true and lawful attorney-in-fact for me in my
name, place and stead to do any or all of the following acts and deeds, to wit:
1. Authorizing her to represent, negotiate, transact, and process all papers in connection with
my application and registration of a startup Photocopy and Print business situated at
;
2. To sign for and in my behalf the all pertinent and related documents, for this purpose;
3. To secure and/or receive the copy of the DTI Certificate of Business Name Registration, BIR
Certificate of Registration, and the Mayors Permit for and in my name including any and all
documents that may be issued relative to the business described above;
4. To sign/do and perform all acts which is necessary and proper to attain the foregoing.
HEREBY GIVING AND GRANTING unto my said attorney-in-fact full power and authority
to do and perform any and all acts as may requisite or necessary to carry into effect the foregoing
authority as fully to all intents and purposes as I might or could lawfully do as if I were personally
present.
IN WITNESS WHEREOF, I have hereunto set my hand in this _______ day of
_______________________________, 2016, at _________________________________.

CONFORME:

Attorney-in-Fact
SIGNED IN THE PRESENCE OF:

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES )
)S.S.
BEFORE ME, this ____day of _____________ 20___, at
Name

CTC No.

, personally appeared:
Date/Place Issued

who have made themselves known to me to be the same person who executed the foregoing instrument, and
they acknowledged to me that the same is their own free and voluntary act and deed.
WITNESS MY HAND AND SEAL, on this ______ day of _____________, 20____, at the place first above
written.
Doc. No. ________;
Book No. ________;
Page No. ________;

Series of 20_______.

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