Special Power of Attorney - Template, Sample Form

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ________, Filipino, of legal age, single, with residence and postal address at ________, and holder of ________ with number ________ (the "Principal"), do hereby NAME, CONSTITUTE, and APPOINT ________, Filipino, of legal age, ________, with residence and postal address at ________, and holder of ________ with number ________ (the "Attorney-in-Fact"), to be my true and lawful attorney-in-fact, for me and in my name, place, and stead, pursuant to Articles 1868 to 1932 of the Civil Code of the Philippines, to do and perform the following acts and deeds, the same being effective until ________, unless sooner revoked in writing by the Principal:

§ 1. Specific Authority. ________

§ 2. Incidental Authority. To execute, sign, deliver, and receive any and all documents, instruments, papers, and receipts; to appear before, transact with, and submit any requirement to any government office or agency, bank, corporation, or private person; and to do any and all acts necessary, proper, or incidental to carry out and accomplish the specific authority granted in § 1 hereof.

§ 3. General Grant. HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and authority to do and perform each and every act and thing requisite, necessary, or proper to be done in and about the premises, as fully to all intents and purposes as I might or could lawfully do if personally present and acting in person, with full power of substitution and revocation.

§ 4. Limitation of Authority. The authority herein granted is special and limited to the acts expressly enumerated above. The Attorney-in-Fact shall not exercise any power not specifically conferred, and any act done beyond the scope of this Special Power of Attorney shall not bind the Principal pursuant to Article 1881 of the Civil Code of the Philippines.

§ 5. Ratification and Confirmation. HEREBY RATIFYING AND CONFIRMING all that my said Attorney-in-Fact shall lawfully do or cause to be done by virtue of these presents.

§ 6. Effectivity and Revocation. This Special Power of Attorney shall take effect upon its execution and shall remain valid and binding until the date stated above or until expressly revoked in writing by the Principal, whichever comes first. Notice of revocation shall be given to the Attorney-in-Fact and to all parties with whom the Attorney-in-Fact has dealt, in accordance with Articles 1920 and 1921 of the Civil Code of the Philippines.

§ 7. Data Privacy. The parties consent to the collection, use, and processing of their personal data contained herein solely for the purposes of executing and giving effect to this instrument, in accordance with the Data Privacy Act of 2012 (Republic Act No. 10173) and its implementing rules and regulations.

IN WITNESS WHEREOF, I have hereunto set my hand at the City/Municipality of ________, Province of ________, this ________.

________
Principal

Conforme:

________
Attorney-in-Fact

Signed in the presence of:

________

________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES   )
________  ) S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, this ________ day of ________, 20________, personally appeared the following:

________, with competent proof of identity consisting of ________;

________, with competent proof of identity consisting of ________;

all known to me and to me known to be the same persons who executed the foregoing SPECIAL POWER OF ATTORNEY, consisting of ________ pages including the page on which this Acknowledgment is written, and signed by the parties and their instrumental witnesses on each and every page hereof, and they acknowledged to me that the same is their free and voluntary act and deed.

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________
Notary Public
Until ________
PTR No. ________
IBP No. ________
Roll of Attorneys No. ________
MCLE Compliance No. ________

Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.