SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, [NAME OF PRINCIPAL], Filipino, of legal age, widow, and a

resident of [Address], do hereby NAME, APPOINT and
CONSTITUTE [NAME OF ATTORNEY-IN-FACT], Filipino, of legal
age, married and a resident of [Address], to be my true and lawful
attorney-in-fact, for me and in my name, place, and stead, and on my
behalf to do and execute any and/or all of the following acts, deeds,
and things, to wit:

1. To secure from the Office of the Bar Confidant,

Supreme Court of the Philippines, Manila my Bar
Confidant Clearance, in support of my application for the
renewal of my notarial commission;

2. To sign any document necessary to secure the release

of the Bar Confidant Clearance, and to receive the same;
and

3. To do any other acts and deeds related to the

foregoing authority.

HEREBY GIVING AND GRANTING unto my said attorney, full

power and authority to perform all acts necessary to carry into effect
the foregoing authority to all intents and purposes that I may do if
personally present and hereby CONFIRMING and RATIFYING all
that my said attorney shall do or cause to be done by virtue of these
presents;

IN WITNESS WHEREOF, I have hereunto set my hand and

affixed my signature this [Date] in [Place].

[NAME OF PRINCIPAL]
Principal
[Competent Proof of Identification]
[Issuing Agency]
[Expiration Date]

Signed in the presence of:

1. [NAME OF WITNESS 1] 2. [NAME OF WITNESS 2]

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 ACKNOWLEDGMENT

Republic of the Philippines )

[Province and/or City] )S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction,

personally appeared the above-named party with her valid
identification document shown below her name, known to me and to
me known to be the same person who executed the foregoing
instrument and hereby acknowledged to me that the same is her free
and voluntary act and deed.

WITNESS MY HAND AND SEAL the place, day, and year

above-written.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2019.

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