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I, (Name of Principal), of legal age, single/married to (Name of spouse if any),
Filipino, a resident of (Address), do hereby name, constitute, and appoint (Name of
Agent /Attorney-In-Fact), to be my true and lawful attorney, for me and in my
name, place, and stead, to do and perform the following acts and things to wit:
To ask, demand, collect any and all sums of money, sue to recover debts, dues,
accounts, dividends, legacies, bequests, interests , and other things of value of
whatever nature or kind as may now be or may hereafter become due owing,
payable or belonging to me, and to have, sue, and to take any all lawful ways and
means for the recovery thereof by suit, attachment, compromise or otherwise;
To make, sign, execute, and deliver contracts, agreements, documents and other
writings of whatever nature or kind, with any and all third persons, entities or
concerns, upon terms and conditions acceptable to my said attorney;
To delegate in whole or in part any all of the powers herein granted or
conferred, by means of an instrument in writing, favor of any third persons whom
my said attorney may select;
HEREBY GIVING AND GRANTING unto my said attorney full power and
authority whatsoever requisite or necessary or proper to be done in and about the
premises as fully to all intents and purposes as I might and could lawfully do if
personally present, with power of substitution and revocation, and hereby, ratifying
and confirming all that my said attorney or his substitute shall lawfully do or cause
to be done under and by virtue of these presents.
IN WITNESS WHEREOF, We have hereunto affixed our signatures this
___________ day of ____________________ , 20__ in ______________________,


(Agent /Attorney-In-Fact)

Signed in the presence of:



Republic of the Philippines)

) S.S

BEFORE ME, personally appeared:



(Name of Principal)
Paranaque City
(Name of Agent)
Mandaluyong City

CTC Number



February 24, 20__ /


January 28, 20__ /

Known to me and to me known 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 20___.