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I, -, of legal age, Filipino, married, and a resident of - hereby appoint, name and constitute - of legal
age, Filipino, and a resident of -, as my true and lawful attorney and representative to do any and all of the following
acts and deeds:

1. To transact, process, negotiate, and inquire with the Embassy of India Releasing Department, particularly in all
matters necessary to claim, obtain and secure my ---

2. To inspect, peruse, copy, and request/obtain all necessary documents, data, and information relevant thereto;

3. To represent me, process, inquire with, and negotiate with the --- for the acquisition of clearances and other
necessary documents;

4. To represent me in any of the related government agencies or private institutions for any purpose or purposes
whatsoever and do all acts as may be expedient before the same or in connection therewith;

5. To make, sign and execute all documents and papers for and in my behalf which are required or necessary
under the circumstances;

6. And, finally, to do such other acts and deeds which may have been omitted in the preceding paragraphs.

HEREBY GIVING AND GRANTING unto my said Attorney-in-fact full power and authority to do and
perform all and every act requisite or necessary to carry into effect the foregoing authority, as fully to all intents
and purposes as we might or could lawfully do if personally present, with the power of substitution and
revocation, and hereby ratifying and confirming all that my said attorney-in-fact shall do or cause to be done by
virtue hereof.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day of September, 2017 at -.

Signed in the presence of:

Principal _______________________ and _________________________

Republic of the Philippines )

City of ---- )S.S.


BEFORE ME, a Notary Public for and in the above jurisdiction personally appeared the above named
person with her competent evidence of identity as shown under her name, and who executed the foregoing
Special Power of Attorney and acknowledged to me that the same is her free act and voluntary deed.

This instrument has been signed by the principal together with her instrumental witnesses.

WITNESS MY HAND AND SEAL on _____ day of September, 2017 at -.

Doc. No._______;
Page No. ______;
Book No. ______;
Series of 2017.