Anda di halaman 1dari 2

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, __________________________, of legal age, Filipino and with


postal address at ______________________________________, Rizal,
do hereby APPOINT, NAME and CONSTITUTE,
________________________________ with postal address at
__________________________, to be my true and lawful attorney-in-fact
and to do and perform the following:

1. To initiate and/or file in my behalf the application for the issuance and
renewal of a Certificate of Public Convenience (CPC) to operate a
Transportation Network Vehicle Service (TNVS) before the Land
Transportation Franchising and Regulatory Board (LTFRB);

2. To appear and represent me in the preliminary conference, presentation


of formal offer of evidence, hearing or any proceedings in the LTFRB
regarding the aforesaid application and/or renewal;

3. To receive the decision as well as other notices and processes of the


Honorable Board regarding the aforementioned application and/or
renewal;

4. To receive my Provisionary Authority to operate as TNVS; and

5. To perform any act or sign or deliver any document, and to perform


such other matters as required and may aid in the prompt
consummation of the foregoing authority.

HEREBY GIVING AND GRANTING unto my said attorney-in-fact full


power and authority to do and perform any and every act and thing whatsoever
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; and

HEREBY RATIFYING AND CONFIRMING all that my said attorney-


in-fact shall lawfully do and cause to be done under and by virtue of these
presents.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of


_______ at ____________.

_______________________ ____________________-
Principal Atty-in-fact

SIGNED IN THE PRESENCE OF:

________________________ ________________________
Witness Witness
Page - 2 -

REPUBLIC OF THE PHILIPPINES)


CITY OF ) S.S.

Personally came and appeared before me this ___ day of ________, at


_________, with Postal Identity Card No. _______________ and
__________________, known to me and to me known to be the same person
who executed the foregoing instrument, and acknowledged that the same is
his/her free act and voluntary deed.

This instrument consisting of 2 (Two) pages, including this whereon the


acknowledgment is written, has been signed by the party and witnesses on each
and every page thereof.

WITNESS MY HAND AND SEAL, at the place and on the date first
above written.

Doc. No. __;


Page No. __;
Book No. __;
Series of ___.

Anda mungkin juga menyukai