SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

We,

of legal age, Filipino and a resident of

, Oriental Mindoro, do hereby NAME, APPOINT AND CONSTITUTE
,
also
of
legal
age,
Filipino,
residing
at
Brgy.________________________Oriental Mindoro, to be my true and lawful attorney-in-fact, for me
and in my name, place and stead, to mortgage, re-mortgage, to extend the term of the mortgage and
to amend the said existing mortgage, to sell, lease, agree for in any manner dispose of the land
together with the improvements now existing or which may hereafter be made thereon belonging to
me situated at Brgy.
, Oriental Mindoro embraced and
covered by Transfer Certificate Title TBook No. T , Page No.
, issued by the Register of Deeds of Oriental Mindoro, containing an area of
(
) SQUARE METERS, upon such term and conditions of under such
covenants as he may deem fit; to RURAL BANK OF PINAMALAYAN (OR.MIN.) INC. or to any
branches in the amount not exceeding
(PHP
) PESOS;
GIVING AND GRANTING unto my representative full power and authority to execute and
perform every act and things whatsoever and necessary to be done in and about the premises, as full
to all intent and purpose as I might or could if personally present, and hereby ratifying and conforming
all that my said attorney shall lawfully do or cause to be done by virtue of these presents:
The Attorney In Fact hereby and herein accepts this appointment as such by the
principal and undertakes to inform the Rural Bank of Pinamalayan (Or. Mdo.), Inc. of any subsequent
death or any event or circumstances that may have affect the mental capacity of the principal most
especially before the renewal of application or additional loan that the Attorney-in-fact may secure on
the strength of this continuing Special Power of Attorney subject to a claim for damages or any other
action against him by the Rural Bank of Pinamalayan (Or. Mdo), Inc. for otherwise failing in such
undertakings.
at

IN WITNESS WHEREOF, I have hereunto set my hand this

Oriental Mindoro.

Principal

day of

Principal

Tin #:

Tin #:

Attorney In Fact
Ctc No.
Issued on:
SIGNED IN THE PRESENCE OF:

REPUBLIC OF THE PHILIPPINES

PROVINCE OF ORIENTAL MINDORO
MUNICIPALITY OF

ACKNOWLEDGEMENT
)
)S.S.
)

BEFORE ME, a notary public and in the above jurisdiction, personally appeared
with residence certificates written below their names,
known to me to be the same person who executed the foregoing instrument and acknowledge the
same to be their own will act and deed.
WITNESS MY HAND AND SEAL, this
, Oriental Mindoro.
Doc. No.
Page No.
Book No.
Series of 20

day of

at