SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ___________________________, of legal age, married, resident of ________________, do hereby name, constitute, and appoint ___________________, my wife, of legal age, married, resident of _____________________, to be my true and lawful attorney, for me and in my name, place, and stead to PROCESS, SECURE AND CLAIM my separation pay or benefits, or any other separation grants, from _____________________, ________________, after resigning therefrom effective _______________, 2013.

HEREBY GIVING AND GRANTING unto my said attorney full powers 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 I might or could lawfully do if personally present and hereby ratifying and confirming all that my said attorney shall lawfully do or cause to be done by virtue hereof.

            IN WITNESS WHEREOF, I have hereunto set my hand this ________ day of __________, in ________________________, Philippines.

__________________________

Signed in the presence of:

_______________________

_______________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES       

PROVINCE OF _______________

CITY OF ____________________

            BEFORE ME, this _______ day of ____________ 2013 in the City of _______________________, Province of _____________________, Philippines, personally appeared _____________________, with Residence Certificate No. _______________, issued at ______________________, on _______________, known to me to be the same person who executed the foregoing instrument, and he acknowledged to me that the same is her free act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand, the day, the year, and place above written.

NOTARY PUBLIC

  My commission expires__________________, 20_____

Not. Reg. No. _________;

Page No. _____________;

Book No. _____________;

Series of 20______