SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, _____________________________________, of legal age, Filipino

citizen, with residence at _________________________________________, by
these presents hereby constitute, name and appoint
________________________________________ of _____________________, to be my
true and lawful attorney, to act on my behalf and in my name, to execute
and perform all or any of the following acts, deeds, matters and thing, in
connection with the application and procurement of my birth certificate to
wit:

1. To apply for and secure a certified true copy of my birth certificate

issued by the Local Civil Registry of Parañaque, Metro Manila;
2. To procure such other documents pertaining to the application of the
same;
3. To perform any and all acts and deeds as well as to execute, sign,
deliver, submit, follow-up, receive, enter into and conclude, any and
all documents, papers, and to comply with any and all requirements,
terms and conditions, necessary, incidental and required for the
immediate processing of the said certified copy of my birth certificate.

HEREBY GIVING AND GRANTING unto said attorney full power and
authority to do and perform all and every act requisite or necessary to carry
into effect the foregoing powers as fully to all intents and purposes as I
might or could lawfully do if personally present, with full power of
substitution or revocation, and hereby ratifying and confirming all that my
said attorney or her substitute shall lawfully do or cause to be done by
virtue hereof.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_____day of _________________ 2019 in the City of __________________.

___________________________________
Principal

Conforme:

________________________________

1
 Attorney-in-Fact

Signed in the presence of:

__________________________________ _____________________________

ACKNOWLEDGMENT

Republic of the Philippines)

City of _______________, MM ) S.S

BEFORE ME, a Notary Public for and in the City of Parañaque, this
____th day of ___________, 2019, personally appeared the following:

NAME ID NO. PLACE DATE

Known to me and to me known to be the same persons who executed the

foregoing SPECIAL POWER OF ATTORNEY consisting of two (2) pages
including the page on which this acknowledgment is written and who
acknowledged to me that the same is their free and voluntary act and deed.

IN WITNESS WHEREOF, I have placed my hand and seal on the date

and at the place for and first above-written.

Doc. No._____;
Page No._____;
Book No. ____;
Series of 2019.