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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, __________________, of legal age, Filipino, married, and a resident of


Caloocan city, Philippines, do hereby depose and state:
1. That I am the brother of _________who died on _____________ in Geneva,
Switzerland;
2. That _____________ was single at the time of her death and she had no
children;

FURTHER, I, _______________, do hereby name, constitute, authorize and


appoint The Philippine Consulate General in Geneva, Switzerland as my true and
lawful attorney in-fact to act, for and in my stead, to do and perform the following acts
deeds and things, to wit:

To facilitate the transport of the remains of ____________ from


Geneva, Switzerland to the Philippines;

To arrange the flight departure and arrival of the remains of


__________________ in the Philippines;

To do such any other act or thing that may be required necessary or


incidental to carry out effectively any and all of the purposes for which
this authority is hereby given;

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full power and
authority to do and perform any and every act, and thing whatsoever requisite and
necessary to be done in and about the premises, 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-in-fact shall lawfully do or cause to be done by virtue of these
presents.

IN WITNESS WHEREOF, we have hereunto set my hand this 2nd day of


November, 2016 at Caloocan city, Philippines .

Principal

SIGNED IN THE PRESENCE OF :

_____________________

______________________

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
City of Caloocan

) s.s.

BEFORE ME, a Notary Public for and in Caloocan city, Philippines this 2 nd day of
November, 2016, personally appeared: __________________________, known to me
and to me known to be the same person who executed the foregoing instrument and he
acknowledged to me that the same is his own free and voluntary act and deed.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2016.

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