SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ___________married to ____,of legal age, with residence and postal address at ____________ do hereby
APPOINT ________________ single/married (insert name of spouse if married), likewise of legal age,
with postal address at _______ as our true and legal representative to act for and in our name and
stead and to perform the following act/s:

To receive my salary that will be turned over by the Human Resource

Department of ______________., including any and all emoluments,
bonuses, or grants which I may be entitled thereto pursuant to my
previous employment thereto.

HEREBY GRANTING our representative full power and authority to execute and perform every
act necessary to render effective the power to receive my salary, as though we ourselves, have
so performed it, and HEREBY APPROVING ALL that he may do by virtue hereof with full rig ht
of substitution of his person and revocation of this instrument.

IN WITNESS WHEREOF, WE HAVE HEREUNTO SET OUR HANDS THIS ____ DAY OF
_______________ 20__, AT (Insert Place of execution of this Instrument).

_______________________________ __________________________________
(Name of Principal) (Name of Agent /Attorney-In-Fact)

Signed in the presence of:

_____________________________ ___________________________________

Republic of the Philippines)

Makati City ) S.S.

SUBSCRIBED AND SWORN before my this ____ of _____ by ____________, exhibiting to me his
______with serial number ______, and known to me to be the same persons who executed the
foregoing instrument and acknowledged to me that the same is their free and voluntary act and
deed.

WITNESS MY HAND AND SEAL, on the date and place first above written.

Notary Public

Doc. No.______;
Page No. ______;
Book No.______;
Series of 2018.