SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
THAT WE, _________________________ of legal age, Filipino, with address at
Trancoville, Baguio City, have made, constituted, and appointed
______________________, also of legal age, Filipino with office address at
__________________Baguio City, as my true and lawful attorney in fact, for me and in
my name, place and stead, to perform the following acts:
1. To be our true and legal representative to act for and in our name and
stead and to represent me in the Philippine Statistics Authority (PSA) –
Baguio City for my application of the following documents:
2. To sign, execute, deliver papers and/or other documents with the above-
mentioned government agency for the purpose stated above.
3. To RECEIVE on our behalf the said papers and/or other documents from
the above-mentioned government agency for the purpose stated above.
4. To do all other acts necessary to carry into effect and fulfill the above-
named purposes.
HEREBY GIVING AND GRANTING unto our 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, as fully, to all intents and purposes, as
We might or could do if personally present and hereby ratifying and confirming all that
my said attorney in fact shall lawfully do or cause to be done by virtue thereof.
IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of March
2022.
_________________________ ________________________
Signed in the presence of:
Republic of the Philippines)
_________________, Benguet)
BEFORE ME, a Notary Public for and in ___________________, Philippines this
4th day of March 2022, personally appeared who presented to me their competent
evidence of identity indicated below their names, known to me and to me known to be
the same person who executed the foregoing instrument and who acknowledged to me
that the same is his act and voluntary deed.
WITNESS MY HAND AND SEAL
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