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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I/WE: _______________, _______________ and _______________,


of legal age/s, Filipino/s and a/resident/s of _______________,
_______________ and _______________, respectively, hereinafter called
the GRANTOR/S, have by these presents, named, constituted and appointed,
_______________, of legal age, Filipino, and a resident of
_______________, and/or _______________, of legal age, Filipino and a
resident of _______________, hereinafter called ATTORNEY/S-IN-FACT,
as I/we hereby name, constitute and appoint said person/s to perform, either
individually or together with the other, all or any of the following acts and
deeds in my/our stead, thus:

1. To file and institute any action, case or proceeding before any


court or tribunal for the purpose of _______________, including
attorney’s fees and all kinds of damages from the _______________
and/or other responsible persons or entities; [or to file any answer or
response to the Complaint/Petition filed against me/us before the
_______________ docketed as Civil/Criminal Case No.
____________ entitled _______________];

2. In the event of an adverse decision, judgment, or order, to


appeal or question said decision, judgment or order to the Regional
Trial Court, Court of Appeals and/or the Supreme Court, as my/our
attorney/s-in-fact may deem proper; in the event an appeal or other
proceeding/s is taken against me/us by the adverse party or other
person or entity, to represent me/us before the appropriate tribunal/s or
court/s;

3. To sign the Verification and/or Certification of Non-Forum


Shopping for the complaint/petition/answer/comment or other
pleading before the Municipal/Regional Trial Court, the Court of
Appeals and/or the Supreme Court and to sign all documents or
pleadings where my/our signature is/are needed;

4. To represent me/us in all stages of the proceedings before the


Municipal/Regional Trial Court, the Court of Appeals and/or the
Supreme Court and to sign any and all documents before said court/s
where my/our signature is/are needed;

5. To represent me/us in the pre-trial and all stages of said case,


action or proceeding filed in my/our behalf/against me/us before the
appropriate court or tribunal; to enter into a compromise agreement or
amicable settlement in my/our behalf and to sign any and all contracts,
pleadings and documents in relation thereto; to enter into admissions
or stipulations of facts, referral of the case to mediation or a
commissioner, or such other proceedings in order to simplify and/or
expedite the trial of the case; to withdraw or cause the dismissal of the
complaint, petition or other proceeding under terms and conditions
that my/our attorney/s-in-fact may deem proper;

6. To receive any and all awards of property or money in my/our


behalf and to dispose or sell said property and/or disburse said money
in payment of any and all expenses incurred in connection with the
case/s filed or answered, such as but not limited to, litigation
expenses, attorney’s fees and other necessary expenses and to pay
unto me/us the remainder after said expenses have been paid and
satisfied;

7. To hire any lawyer/s and/or law office for this purpose and to
enter into a contract for legal services, including the payment of
attorney’s fees;

8. To sign, execute, and indorse such paper or document as may


be necessary or required in the foregoing premises; and

9. To perform any and all acts necessary for the implementation of


this power of attorney.

10. My/our attorney/s-in-fact is/are expressly empowered to


appoint a substitute in his/her/their stead without any prior consent on
my/our part and for reasons that my/our attorney/s-in-fact may deem
justified.

HEREBY GIVING AND GRANTING unto said attorney/s-in-fact full


power and authority to do and perform any and all acts and deeds necessary
to be done fully to all intents and purposes as I/we might or could lawfully
do if personally present and hereby confirming and ratifying all that my/our
said attorney/s-in-fact shall lawfully do or cause to be done by virtue of
these presents.

IN WITNESS WHEREOF, I/we have hereunto affixed my/our


signature/s this _____ day of __________ at __________.

____________________ ____________________

2
Principal/Grantor Principal/Grantor

With my/our Conformity


__________________ __________________
Attorney-in-fact Attorney-in-fact

Signed in the Presence Of:

1. ____________________ 2. ____________________

***

Republic of the Philippines )


Province of Leyte ) SS.
City of Tacloban/Ormoc )

ACKNOWLEDGMENT

BEFORE ME a notary public for and in the above jurisdiction, this


_____ day of _____________ 20___, personally appeared the following
person(s) exhibiting his/her/their identification card(s), the particulars of
which are indicated beside his/her/their name(s):

Name Identification Card & No. Issued On /At

____________________ _____________________ ________/________

____________________ _____________________ ________/________

____________________ _____________________ ________/________

____________________ _____________________ ________/________

and who is/are –


[ ] personally known to me; or
[ ] his/her/their identity(ies) having been proved to me through competent
evidence:
[ ] identification card indicated above; or
[ ] oath/affirmation of _______________ who is not privy to the
instrument, is personally known to me and who personally knows the
affiant; or
[ ] oath/affirmation of _______________ and _______________, who
showed their respective identification cards _______________ and
_______________, who are not privy to the instrument and who
personally knows the affiant.

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to be the same person(s), whose name(s), together with those of the
witness/es, is/are subscribed to the said instrument and in each and every
page thereof, and who acknowledged to me that he/she/they executed the
same voluntarily and in his/her/their authorized capacity.

This acknowledgment is attached to a Special Power of Attorney,


dated _______________ consisting of _____ pages, including this page
where the acknowledgement is written.

Witness my hand and official seal.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 20___.

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