SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, _____, of legal age, Filipino citizen and a resident of ________________, have made,
constituted and appointed, and by these presents do hereby make, constitute and appoint:

______ of legal age, Filipino citizen and with office address ______, to be my true and
lawfull ATTORNEY-IN-FACT for me and in my name, place and stead to act for me, and in my
behalf and present me for the following:

HEREBY GIVING AND GRANTING unto the said Attorney-in-Fact full power of and
authority whatsoever requisite and necessary or proper to be done in or about the premises as fully
to all intents and purposes as I might or lawfully do if personally present and hereby ratifying
and conforming all that my said Attorney-in-Fact shall do or cause to be done under and by virtue
of this presents.

IN WITNESS WHEREOF, I have here unto affixed our hands this____th day
of_______________________at Dagupan City,Philippines

(Affiant)

(Atty-in-fact)

Signed in the presence of:

(Print Name & Sign) (Print Name & Sign)

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

CITY OF DAGUPAN...) S.S.

BEFORE ME, personally appeared the person mentioned of the above named parties with
Her identification no. below her respected name made known to me that same are their own free
act and voluntary deed.

WITNESS MY HAND AND NOTARIAL SEAL, on the date place first started above.
Doc. No. _____
Page No.______
Book No.______
Series of 2016 Notary Public