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I, ____, Filipino citizen of legal age, Single, with residence at ________, hereby name, appoint
and constitute _____________, likewise of legal age, Single, and with address at
___________________ 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 things, to wit:
HEREBY GIVING AND GRANTING unto our said attorney full powers 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 and revocation, and hereby ratifying and confirming all that my said attorney or his
substitute shall lawfully do or cause to be done by virtue hereof.
_____________________________ _______________________________
_________________________ _________________________
ACKNOWLEDGMENT
known to me and to me known to be the same person/s who executed the foregoing Special
Power of Attorney consisting of 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 first
above-written.
NOTARY PUBLIC
I, KRISTINE MAE PUYO URBI, Filipino citizen of legal age, Single, with residence at Unit 334,
Eagle Court Condominium, 26 Matalino St., Barangay Central, Diliman Quezon City Philippines,
hereby name, appoint and constitute KARLA ANTONETTE PUYO URBI, likewise of legal age,
Single, and with address at Unit 334, Eagle Court Condominium, 26 Matalino St., Barangay
Central, Diliman Quezon City Philippines 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
things, to wit:
1. To process and claim my Regional Trial Court and Metropolitan Trial Court Clearance;
2. To make, sign and execute, for and in my behalf, any documents which may be necessary
for release of my RTC and MTC Clearance;
3. To appear in my name and in my stead before any government agencies;
4. To do or undertake any other action which may in his absolute discretion deem necessary
or conducive the processing and release of my RTC and MTC Clearance.
HEREBY GIVING AND GRANTING unto our said attorney full powers 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 and revocation, and hereby ratifying and confirming all that my said attorney or his
substitute shall lawfully do or cause to be done by virtue hereof.
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of ________________
2019, at ____________________, Philippines.
_____________________________ _______________________________
_________________________ _________________________
ACKNOWLEDGMENT
IN WITNESS WHEREOF, I have placed my hand and seal on the date and at the place first
above-written.
NOTARY PUBLIC