SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

, Filipino, of legal age with address at No., Malate, Manila hereby

name, constitute and appoint:

single, of legal age, with residence address at to be my true and lawful

Attorney-in-Fact, for my name and stead, and for my own use and benefit,
to do and perform all or any of the following acts and things, namely:

1. To represent me in the issuance, request, endorsement of my

Renewal forms, and any other documents from
PROFESSIONAL REGULATION COMMISSION (PRC), 2nd
Floor, Robinsons Place Manila, Pedro Gil St., Manila City.

2. To receive my newly issued PRC license and any other

documents from PROFESSIONAL REGULATION
COMMISSION (PRC).

3. To submit, sign, pay and execute any document necessary in

relation to my request for the issuance of the above mentioned
documents.

4. To do and perform all such other acts and things requisite

and/or necessary to effectively and successfully carry out the
above-mentioned purpose.

HEREBY GIVING AND GRANTING unto said Attorney-in-Fact

full power and authority to do and perform all and every act and thing
whatsoever requisite and necessary to be done in and about the premises
and HEREBY RATIFYING AND CONFIRMING all that said Attorney-in-
Fact shall lawfully do or cause to be done by virtue of this Special Power of
Attorney.

IN WITNESS WHEREOF, I have signed this Special Power of

Attorney this ____day of January 2020 in the City of Manila.

Affiant
 [ 2]

SIGNED IN THE PRESENCE OF:

_______________________ ______________________

ACKNOWLEDGMENT

Republic of the Philippines)

City of Manila ) S.S.

Before me ____day of __________ 2020 in the City of Manila, affiant

exhibited to me his Philippine Passport with No. __________ issued by the
Department of Foreign Affairs, Manila, known to me and to me known to
be the same person who executed the foregoing Special Power of Attorney
consisting of two (2) pages including this page and acknowledged to me
that the same is her free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and at the place first
written above.

Doc. No. _____;

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