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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS;

WE, xxxxxxxxxxx, both of legal ages, married, with residential


address at xxxxxxxxxxxxxxxxx, by these presents, do hereby NAME,
CONSTITUTE and APPOINT xxxxxxxxxxxxxxxxx, with postal
address at xxxxxxxxxxxxxxxx, to be our true and lawful attorneys-in-
fact, in coordinating with the MINISTRY OF FOREIGN AFFAIRS OF
DENMARK IN THE PHILIPPINES, UNITED STATES OF AMERICA
EMBASSY IN THE PHILIPPINES, REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF FOREIGN AFFAIRS, BUREAU OF
IMMIGRATION, REPUBLIC OF THE PHILIPPINES PHILIPPINE
STATISTICS AUTHORITY, NATIONAL INTELLIGENCE
COORDINATING AGENCY, PHILIPPINE
CONSULATE/EMBASSY, REPUBLIC OF THE PHILIPPINES
NATIONAL BUREAU OF INVESTIGATION, and other government
agencies or departments to process, request, authenticate, submit,
claim any documents on our behalf, with full power to do and
perform the following acts, to wit:

(a) To represent, receive and claim the documents that


may be necessary or proper to carry into effect the
powers hereby granted;

(b) To make, execute, sign, acknowledge and deliver any


deed, document or instrument in writing, that may be
necessary or proper to carry into effect the powers
hereby granted;

(c) To request copies, or authentication of any deed,


document or instrument in writing, that may be
necessary;

(d)To do and perform all and every act and thing which
may be requisite, necessary or proper to carry out the
above purposes;

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(e) To take other actions, as they may deem necessary or
appropriate in the exercise of the powers hereby
granted, the necessity or appropriateness thereof
being conclusively established by the actions taken.

HEREBY GIVING AND GRANTING unto said attorneys-in-


fact, full power and authority to do and perform all and every act,
requisite and 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 power of substitution and hereby ratifying
confirming all that said attorneys-in-fact shall lawfully do or cause to
be done by virtue hereof.

IN WITNESS WHEREOF, we have hereunto set our hands this


____ day of __________________________ 2018 at
_______________________.

xxxxxx

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES ]


] SS

BEFORE ME, a notary public, this ______ day of


__________________ 2018, personally appeared the following:

xxxxxxxxxx exhibiting to me his Passport with I.D. No.


xxxxxxxx issued on xxxxxxxxx expiring on xxxxxxxx, and

xxxxxxxxxx exhibiting to me her Passport with I.D. No.


________________________ issued on ___________________ expiring
on ________________________, and

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Both known to me to be the same person who executed the
foregoing instrument, who acknowledged to me that the same is their
true and voluntary act and deed.

This instrument, consisting of three (3) pages, including the


page on which this acknowledgment is written, has been signed by
the parties and their instrumental witnesses on the left margin of
each and every page thereof, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand on the


date and at the place above written.

Doc. No. ______;


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

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