KNOW ALL MEN BY THESE PRESENTS:
I, (NAME PRINCIPAL – The one Authorizing)
____________________ , of legal age, (civil status – single or married?)
_________________________, Filipino, with postal address at ___________________________
(Address), do hereby appoint, name and constitute (NAME OF AGENT – person
authorized) _____________________________, of legal age, Filipino, (single/married?)___________________,
and a resident of (ADDRESS) _____________________________, to be my true and lawful
Attorney-in-Fact for me and in my name, place and stead to do and perform the
following matters, acts, things and deeds:
1. To process my (state details of what you authorize your agent to do)
_________________
______________________________________;
2. To appear on my behalf when needed during the said application and
payment process, and sign documents and make payments on my behalf;
3. In general, to do and perform all acts, matters and things of
administration to make the powers herein granted forceful and effective,
subject to the limitations stated herein.
HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and
authority to do and perform all and every act and things as fully to all
intents and purposes as we might or could lawfully do if personally present,
with full power of substitution and revocation, and hereby ratifying and
confirming all that any of our said attorney-in-fact or his substitutes shall
lawfully do or cause to be done by virtue hereof.
IN WITNESS WHEREOF,
I have hereunto affixed my signature this _____________________ (DATE) at
______________________,
Philippines.
NAME OF PRINCIPAL
Accepted by:
(NAME OF AGENT)
Witnesses: ____________________________ ____________________________
ACKNOWLEDGMENT
REPUBLIC OF THE
PHILIPPINES )
CITY OF CEBU ) S.S.
BEFORE ME A NOTARY PUBLIC, for and
in the City of ___________, on the ___________________, personally appeared NAME OF AGENT ___________________, who has
satisfactorily proven to me his identity by presenting to me his ID no.
_______________________________ issued on _________________ and which expires
on _______________________, which is an identification document duly issued by
a government agency which bear the signature and photograph of the party, and
being informed by me of the contents of the foregoing instrument, he acknowledged
before me that he executed the same on his own free will and deed.
WITNESS MY HAND AND SEAL on the date
and place first above written.
Doc. No. _____
Page No. _____
Book No. _____
Series of _____.
