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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

We, [name], [designation/position], hereby authorize, appoint and designate


[person to be appointed], to be our true and lawful representative in the filing and
prosecution of a criminal case against [accused], for [crime] under Article [number] of
the Revised Penal Code with specific power to sign for and bind us in all pleadings,
papers, documents and agreements, including verifications and certifications of non-
forum shopping, necessary, required and/or desirable in the foregoing.

HEREBY GIVING AND GRANTING unto the said attorney full power and
authority to do and perform all and every act requisite or necessary to carry into effect
the foregoing powers, as fully to all intents and purposes as we might or could lawfully
do if personally present, with all power of substitution and revocation and hereby
ratifying and confirming all that the said attorney or her substitute shall lawfully do or
cause to be done by virtue hereof.

IN WITNESS WHEREOF, we have hereunto set our hand this __________ in


____________.

NAME NAME
TIN TIN
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


) S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, personally
appeared this ______________, the following:

Name Government-Issue Date and Place of Issuance


Identification

[NAME]

[NAME]

known to me and to me known to be the same persons who executed the foregoing
Special Power of Attorney and acknowledged to me that the same is their free and
voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL this _____________ in


______________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of ______.