SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That I, ___________________, of legal age, _________, Filipino, and with residence
and postal address at __________________________________________, do hereby APPOINT,
NAME and CONSTITUTE the SOCIAL SECURITY SYSTEM, a government owned and controlled
corporation, duly created by law, with principal office at SSS Building, East Avenue, Quezon
City, represented by any of its authorized traders as follows: Rizaldy T. Capulong, Donna Fay
Samonte and Alan Joseph Amador, to be my lawful ATTORNEY-IN-FACT for me and in my
name, place and stead, to do any or all of the following acts and things to wit:
1. To SELL my ____________ shares of Stock, which I purchased under the SSS
_________________ loan program;
2. To sign, execute and deliver any and all documents that may be needed or necessary in the
sale of aforesaid shares of stock;
3. To receive any and all sums of money or checks that may be issued in my name by way of
proceeds of the sale and to cash the same with any bank or banking institution;
4. To do any other acts and things which may be needed or requisite in the furtherance of the
foregoing undertaking.
HEREBY GIVING AND GRANTING unto my said Attorney-In-Fact full power and authority
to do and perform every act necessary to render effective the power to sell the foregoing
shares of stock, as though I myself might or could lawfully do if personally present; hereby
ratifying and confirming all that my said Attorney-In-Fact may lawfully do or cause to be done
by virtue of these presents.
IN WITNESS WHEREOF, I hereunto set my hand on this _________ day of
______________, in Quezon City.
_____________________
Grantor
Specimen Signature of:
___________________
Attorney-in-Fact
Signed in the presence of: _____________________
_____________________
REPUBLIC OF THE PHILIPPINES
Quezon City
) S.S.
BEFORE ME, A Notary Public for and in Quezon City personally appeared
________________ with Community Tax Certificate No. __________ issued on ___________ at
___________ known to me to be same person who executed the foregoing instrument and
acknowledged to me that the same is their own free and voluntary act and deed.
WITNESS MY HAND AND OFFICIAL SEAL on the date and place first above written.
Doc. No. :_______
Page No.:_______ Book
No.:_______
Series of _______.