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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________________________, married, of legal age, Filipino, and


with postal address at ________________________________, landowner of a parcel of
land designated as Lot No. _______________, located at _____________________,
have named, constituted, and appointed and by these presents do name, constitute, and
appoint, _______________________, married of legal age Filipino, and with postal
address at ________________________, to be my true and lawful attorney-in-fact, in my
stead, and for my benefit, to do and perform all or any of the following acts, namely:

In relation to the land I own at ___________________________, to represent in


any negotiations with _________________________, regarding my share from the
palay production;

To make, sign, execute, deliver documents, agreements and other writings of


whatever nature or kind, with any and all third persons, concerns, or entities, upon
terms and conditions acceptable to my said attorney-in-fact, including my desire to sell
the aforesaid property on my behalf;

To delegate in whole or in part any or all of the powers herein granted or conferred,
by means of an instrument in writing in favor of any third person or persons whom said
attorney-in-fact may select;

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full power and
authority whatsoever requisite or necessary to be dine in and about the premises as fully
to all intents and purposes as I might or could lawfully do if personally present, hereby
ratifying and confirming all that my said attorney-in-fact shall lawfully do or cause to be
done by virtue of these presents.

IN WITNESS THEREOF, I have hereunto set my hand this __ day of __________,


20__ at ________ City, Philippines

____________________________________
Affiant
Competent Evidence of Identity
ID : _________________
Issued on : ___________
At : _________________
SIGNED IN THE PRESENCE OF

____________________________ ____________________________
________________ ________________
Witness Witness

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF _______________ ) S.S.
MUNICIPALITY/CITY OF _______ )

SUBSCRIBED and SWORN TO before me on the date and at the place indicated
below. The affiant exhibited to me her competent evidence of identity as indicated above,
known to me to be the same person who executed the foregoing instrument and
acknowledged to me that the same is her free act and deed.

Signed this _____________ at _____________, Philippines.

WITNESS MY HAND AND SEAL.

Notary Public

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 20___.

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