SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, of legal age, single and a resident of, do hereby appoint, name
and constitute to be my true and lawful attorney to act in, manage and
conduct all my affairs, and for that purpose in my name and in my behalf to
do and execute all of any of the following acts, deeds and things:
1. To make a representation in my behalf in Criminal Case No.
___ for pending before the, Branch ___, that I filed against
_____________;
2. To attend in the pre-trial and/or preliminary conference in the
aforesaid criminal action and to enter into stipulations or
admissions of facts during the same as the Rules of Court
may provide and warrant;
3. To submit the case to alternative modes of dispute resolution
and to enter into compromise agreement and/or amicable
settlement in my name and stead in connection with and
related to the aforesaid criminal case.
My attorney-in fact hereby accepts this appointment subject to its
terms and agrees to act and perform in said fiduciary capacity consistent
with my best interest as they in their best discretion deems advisable, and I
affirm and ratify all acts so undertaken.
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, hereby ratifying and
confirming all that said attorney-in-fact shall lawfully do or cause to be done
by virtue of these presents.
This power of attorney may be revoked by me at any time, and shall be
automatically revoked upon my death, provided that any person relying on
my power of attorney before or after death shall be given full rights to accept
the authority of my attorney-in-fact until in receipt of actual notice of
revocation.
IN WITNESS WHEREOF, I have
________________ in __________________.

affixed

my

signature

this

Grantor
Identification Card: _________
Issued at __________
Date of Issue: ______

Signed in the presence of:

_____________________

______________________

Republic of the Philippines

Makati City ) S.S

ACKNOWLEDGMENT
BEFORE ME, a notary public for personally appeared _____________,
with his respective identification card shown below his name. That the party
is known to me and to me known to be the same person who executed the
foregoing instrument and that he acknowledged to me that he executed the
foregoing instrument of their own free will and deed.
This instrument consists of two (2) pages including the page of
which this acknowledgment is written, and signed on each and every page
by the party executing this instrument and their witnesses, and sealed with
my notarial seal.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my
notarial seal, this ______________.

Doc. No.: _______

Page No.: _______
Book No.: ______
Series of _______