Anda di halaman 1dari 1

SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ________________________, of legal age, single, Filipino, and a resident of


_____________________________, Philippines, after having been duly sworn to in
accordance with law, do hereby NAME, CONSTITUTE, and APPOINT
________________________, of legal age, Filipino and a resident of
________________________, Philippines, to be my true and lawful Attorney-in-Fact, in my
name and my behalf, to do and perform all or any of the following acts:

1. To represent me before the Land Transportation Office (LTO) and to any other
government agency with regard the transfer of registration in my name, after having
fully-paid by me in a sale transaction, the following motor vehicle, to wit:

Make:
Engine No.:
Chassis No.:
Model:
Color:
Plate Number:
Certificate of Registration No.:
Official Receipt No.:

2. To comply with all the requirements required of by the LTO and to any government
agency relative to the transfer of registration of said vehicle in my name.

3. To sign documents and do any other acts necessary for the performance of the
above-stated authority.

HEREBY GIVING AND GRANTING my said Attorney-in-Fact full powers and


authority to do and perform all and every act requisite or necessary to be done, as fully to
all intents and purposes as I might or could lawfully do if personally present, and hereby
ratifying and confirming all that my said attorney-in-fact shall do or cause to be done by
virtue of these presents.

_________________________
Principal
I.D. No. _______________

_________________________
Attorney-in-fact
I.D. No. _______________

REPUBLIC OF THE PHILIPPINES)


CITY OF _______________)SS.
x-------------------------------------------x
ACKNOWLEDGMENT

BEFORE ME, Notary Public, for and in the City of ________, Philippines, this ______
day of _____________, personally appeared the parties, known to me and known to be the
person who executed the foregoing instrument and acknowledged that the same is his own
free will and voluntary act and deed.

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

Doc. No. ____


Page No. ____
Book No. ____
Series of ____.