SPECIAL POWER OF ATTORNEY
KNOW ALL MEN THESE PRESENTS:
I, ANA MARIE P. NICOLAS, of legal age, single/married, with residence address at
32 BRONZE ST. SSS VILLAGE CONCEPCION II MARIKINA CITY 1811, do hereby name,
constitute, and appoint MEDIE PERALES CODILLA with address at 32 BRONZE ST. SSS
VILLAGE CONCEPCION II MARIKINA CITY 1811, to be my true and lawful Attorney-in-Fact,
for me and in my name, place, and stead, to do and perform the following acts and things to
wit:
1. To transact, process, follow-up and receive any document/s
with Manila City Hall Civil Registry and Philippine Statistics
Authority pertaining to my “Certificate of Live Birth”
indicating the correct spelling of my name “ANA MARIE P.
NICOLAS PALAFOX NICOLAS ;
2. To make, sign, and execute, other writings of whatever
nature or kind, with any and all third persons, entities or
concerns, as well as RECEIVE, ACCEPT and COLLECT, the
above-cited application, upon terms and conditions
acceptable to my said Attorney-In-Fact;
HEREBY GIVING AND GRANTING unto my said Attorney-In-Fact full power and authority
whatsoever requisite or necessary or proper to be done in and about the premises as fully
to all intents and purposes as I might and could lawfully do if personally present, with
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 under and by virtue of these
presents.
IN WITNESS WHEREOF, we have hereunto affixed our signatures this
____________________________in the __________________________, Philippines.
ANA MARIE P. NICOLAS, M.D MEDIE PERALES CODILLA
Principal Attorney-In-Fact
ACKNOWLEDGMENT
Republic of the Philippines)
) S.S
BEFORE ME, personally appeared:
Name I.D. PRESENTED
ANA MARIE P. NICOLAS
MEDIE PERALES CODILLA
Known to me and to me known to be the same persons who executed the foregoing
instrument and acknowledged to me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, this ________________________ in the City of _______________________,
Philippines.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2019.
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