Thanks to visit codestin.com
Credit goes to www.scribd.com

Scribd
Upload
53 views2 pages

Special Power of Attorney Form

This document is a special power of attorney that appoints someone to process and receive benefits and claims from government agencies on behalf of the principal. It grants full authority to the attorney-in-fact to perform any acts necessary to accomplish receiving benefits, signing documents, and submitting papers to agencies.

Uploaded by

JO-ANN ESTOQUE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
53 views2 pages

Special Power of Attorney Form

This document is a special power of attorney that appoints someone to process and receive benefits and claims from government agencies on behalf of the principal. It grants full authority to the attorney-in-fact to perform any acts necessary to accomplish receiving benefits, signing documents, and submitting papers to agencies.

Uploaded by

JO-ANN ESTOQUE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

REPUBLIC OF THE PHILIPPINES )

CITY OF BAGUIO ) S.S

SPECIAL POWER OF ATTORNEY


I, _______________, Filipino, single/married, of legal age and with present address at
_________________, do hereby NAME, CONSTITUTE AND APPOINT _____________, likewise,
Filipino, single/married, of legal age and with present address at __________________, to be my true
and lawful ATTORNEY-IN-FACT, for me and in my name, place and stead, to do and undertake the
following acts:

1. To PROCESS and FOLLOW UP the release of my remaining Salary, Health


Emergency Allowance (HEA), PHILHEALTH Sharing, Terminal Leave Benefits, Performance Based
Bonus, Meal and Transportation Allowance and all other claims and benefit due me with the BGHMC,
including other claims and benefits with the GSIS, PAG-IBIG and other concerned agencies, and in
the course thereof, SIGN, EXECUTE and DELIVER any and all documents as may be required;
2. To cause the preparation of the required and necessary documents/papers, EXECUTE,
SIGN all documents/papers, and SUBMIT such required papers or documents, and pay the fees
required by all concerned government agencies and RECEIVE for and on my behalf whatever
documents from such government agencies, as well as to do any and all acts in order to accomplish
the aforesaid acts and deeds;

3. To do or perform any act or acts necessary for the accomplishment of the above
mentioned acts.

HEREBY GIVING AND GRANTING unto the said Attorney-in-Fact full powers and authority to
perform all such acts necessary as to all intents and purposes as I might or could lawfully do or cause
to be done by virtue hereof.

IN WITNESS WHEREOF, We have hereunto set our hands this ___________________ in the
________, Philippines.
___________________________
Principal
ID No:
Valid Until:
CONFORME:
____________________________
Attorney-in-Fact
ID No.:

SIGNED IN THE PRESENCE OF:

____________________ ___________________

ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the City of Baguio this ______ day of __________,
________, personally appeared the above named parties known to me to be the same persons who
executed the foregoing instrument and who acknowledged to me that the same is their free and
voluntary act and deed.

WITNESS MY HAND AND SEAL, on the date and place above mentioned.

NOTARY PUBLIC
Doc No. _______;
Page No. _______;
Book No. _______;
Series of _______;

You might also like