Republic of the Philippines )
_____________________) S.S
SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
I,[single], of legal age, with residence and postal address at I do hereby appoint .
, likewise of legal age, with postal address at ___
, as my true and legal representative to act for in my behalf and stead and to perform the
following acts:
To apply, submit, sign and received Applications, Documents, BIR forms pertaining to and any
transactions with the Bureau of Internal Revenue such as but not limited to request new or
transfer of TIN, register as specified and other related matters.
HEREBY APPROVING ALL that he may do by virtue hereof with full right of substitution of his
person and revocation of this instrument.
IN WITNESS WHEREOF , WE HAVE HEREUNTO SET OUR HANDS THIS ____ DAY OF
_______________ 20__, AT___________________________
[Insert signature over printed name] ___________________________
(Name of Principal) (Name of Agent /Attorney-In-Fact)
Signed in the presence of:
_____________________________ ___________________________________
BEFORE ME, personally appeared
Name TIN Date/Place Issued
[insert name] [insert TIN]
Known to me and to me known to be the same persons who executed the foregoing instrument
and acknowledged to me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, on the date and place first above written.
Notary Public
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.