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SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: I SORAYA L. HORI married to TIMOTHY PAUL HORI, of legal age, with residence and postal address at (Address) do hereby APPOINT AURORA B. MACACUA, widow, likewise of legal age, with postal address at (Address) as our true and legal representative to act for and in our name and stead and to perform the following acts: 1. To sign for the me and in my name all papers and documents pertaining to (state nature of transaction and transaction/business name); 2. To collect and receive whatever sum in legal tender any proceeds, payment, interest, return of premium , or otherwise from (state nature of transactio n and transaction/business name).
HEREBY GIVING AND GRANTING unto our said attorney full powers 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 I might or could lawfully do if personally present, with full power of substitution and revocation, and hereby ratifying and confirming all that my said attorney shall lawfully do or cause to be done by virtue hereof. IN WITNESS WHEREOF , WE HAVE HEREUNTO SET OUR HANDS THIS ____ DAY OF _______________ 20__, AT (Insert Place of execution of this Instrument).
_______________________________ (Name of Principal)
__________________________________ (Name of Agent /Attorney-In-Fact)
Republic of the Philippines ) ______________________) S.S
ACKNOWLDEGMENT
BEFORE ME, personally appeared: Name
CTC Number
Date/Place Issued
SORAYA L. HORI AURORA B. MACACUA
Known to me and to me known to be the same persons who executed the foregoing instrument and acknowledged to me that the same is their free and voluntary act and deed. WITNESS MY HAND AND SEAL, on the date and place first above written.
Notary Public
Doc. No.______; Page No. ______; Book No.______; Series of 20___.
