REVOCATION OF SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

WHEREAS, under date of _________________, I, _______________________, have executed a

Special Power of Attorney, naming and appointing _________________ as my true and lawful attorney-
in-fact for the purpose/s and with the power set forth in the instrument which was ratified before
Atty. ______________________, Notary Public in and for ________________, as per Doc. No. ________,
Page. No. __________ Book No. _______________, Series of _____________ of his Notarial Register; and

NOW, THREFORE, I have revoked, countermanded, annulled and made void, and by these
presents do revoke, countermand, annul and make void the said Special Power of Attorney and all
powers and authorities therein granted and conferred upon said attorney-in-fact __________________.
IN WITNESS WHEREOF, I have hereunto set my hand at ________________, on this ______ day of
______________, 20______.

_____________________
(Principal)

SIGNED IN THE PRESENCE OF:

___________________________ ___________________________

ACKNOWLEDGMENT
Republic of the Philippines)
____________ ) SS.

BEFORE ME, a Notary Public in and in _______________ this _______ day of _________________,
2017, personally appeared the following:

Name: ID No./ Date & Place Issue

___________________ ______________ ___________________

all known to me to be the same person who executed by the foregoing instrument and he/she
acknowledged to me that the same is his/her free and voluntary act and deed.

WITHNESS MY HAND AND SEAL in the place and on the date first above written.

Doc. No. _______;

Page No. _______;
Book No. ______;
Series of 20___.