Republic
of the Philippines )
City of (Place) ) S.S.
City of (Place) ) S.S.
REVOCATION
OF POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, under the date of (Date), I, (Name of
Principal), of legal age, single/married, Filipino, and a resident of (Place of Residence), have
executed a Special Power of Attorney, naming and appointing (Name of Attorney-in-Fact), of legal
age, single/married, Filipino, and a resident of (Place of Residence), as my true and lawful attorney-in-fact for
the purpose and with the power set forth in the instrument which was ratified
before Atty. (Name of Notary Public),
Notary Public in and for (Place), as
per Doc. No. _____, Page. No. _____ Book No. _____, Series of _____ of his
Notarial Register; and
NOW, THREFORE, I have revoked, countermanded,
annulled and made void, and by these presents do revoke, countermand, annul and
make void the said Special Power of Attorney and all powers and authorities
therein granted and conferred upon said attorney-in-fact (Name of Attorney-in-Fact).
IN WITNESS WHEREOF, I have hereunto set my hand
this (Day) day of (Month), (Year) in (Place),
Philippines.
(Name of Principal)
Signed in the presence of: _________________________
_________________________
ACKNOWLEDGMENT
BEFORE ME , a Notary Public for and in the City of (Place), this (Date), personally appeared (Name
of Principal) who presented to me his ID No. _____, issued on
______________ at _________________, known to me and to me known to be the same
person/s who executed the foregoing Revocation of Power of Attorney, and who
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
first above-written.
Doc. No.
_____;
Page No.
_____;
Book No.
_____;
Series of
_____.