SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

THAT I, ________________________, of legal age, (single/married),

Filipino citizen, with residence at
_______________________________________________ have made, constituted,
and appointed __________________ also of legal age, Filipino and a resident of
_____________________________________________________, to be my true and
lawful attorney to act in my name and on my behalf and execute any or all of the
following acts, deeds, and things, to wit:

1. To represent, execute, sign, process any and all necessary documents and
papers as well as to do any and all acts relative to the surrender of the Motor
Vehicle covered by Certificate of Registration No. _______________ issued
by the _______________________, in favor of _______________, to wit:

Make :
Series :
Body Type :
Engine No. :
Chassis No. :
MV File :

2. To cause the filing of a suit/defend the same before any courts with respect
to controversy that may arise relative to the surrender of the said Motor
Vehicle;

3. To do such any other act or thing that may be required necessary or

incidental to carry out effectively any and all of the purposes for which this
authority is hereby given

HEREBY GIVING AND GRANTING unto my 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 I 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 ___ day of

______________ 2020.

____________________________
(Name)
Principal
Conforme:
_______________________
(Name)
Attorney-in-fact

SIGNED IN THE PRESENCE OF

________________________ ________________________

ACKNOWLEGMENT

REPUBLIC OF THE PHILIPPINES)

CITY OF BACOLOD) SS.

BEFORE ME A NOTARY PUBLIC for and in the above jurisdiction personally

appeared (name of the Principal) and (name of the Attorney-in-fact), who
exhibited to me their _________________ and _________________, respectively, as
their competent proof of identity, known to me to be the same person who executed
the foregoing instrument which they acknowledged to be their free act and deed.

DOC. NO. _______;

PAGE NO.______;
BOOK NO. ______;
Series of 20__.