SPECIAL POWER OF ATTORNEY
I,SSSSSSSSSSS, of legal age, Filipino citizen, single and a resident of PA 400a, Upper
Wangal, La Trinidad, Benguet, do hereby name, constitute and appoint
FFFFFFFFFFFFFFFFFFFF, of legal age, Filipino citizen, and a resident of Mabini Street,
Barangay Catbangen, City of San Fernando, La Union, to be my true and lawful attorney, to act
on my behalf and in my name, place and stead in my behalf, to perform any and all the
foregoing acts and things:
1. To act as my representative and agent with full authority to secure a copy ofmy Cer-
tificate of Live Birth and Certificate of No Marriage in the Philippine Statistics Author-
ity, as well as my Cedula (Community Tax Certificate), and to secure all other docu-
ments, papers or instruments from different government and private offices neces-
sary for the application of a marriage license;
2. To represent me in all other government and private offices concerned regarding the
application of a marriage license; and
3. To sign, verify, certify, execute, deliver, submit, file, secure and receive all papers,
documents or instruments and other writings which may be necessary and proper to
accomplish the foregoing authority.
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, with full
power of substitution and revocation.
IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ at
San Fernando City, La Union.
SSSSSSSSSSSSSSSSSSSSS
Principal
Signed in the presence of:
________________________ _______________________
Republic of the Philippines)
Province of La Union )
City of San Fernando )s.s.
BEFORE ME, a Notary Public for and in the City of San Fernando, La Union, this
_________________, personally appeared SSSSSSSSSSSSSSS and who is personally known
to me to be the same person who executed the foregoing Special Power of Attorney in favor of
FFFFFFFFFFFFFFFFFFFF, and he acknowledged to me that the same is his free and voluntary
act and deed.
IN WITNESS WHEREOF, I have placed my hand and seal on the date and at the place
above-written.
Doc No._____;
Page No.____;
Book No.____;
Series of 2022.