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(Annex C.) SPA

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Joy Querubin
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225 views

(Annex C.) SPA

Uploaded by

Joy Querubin
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Annex “C”

Republic of the Philippines


Office of the President
NATIONAL COMMISSION OF SENIOR
4th Floor, AAP Tower, 683 Aurora Blvd, Mariana, 1117 Quezon City,
Philippines Official website: www.ncsc.gov.ph

SPECIAL POWER OF ATTORNEY


(FOR DECEASED BENEFICIARY)

KNOW ALL PERSONS BY THESE PRESENTS

WE, , with residence and postal address at


, and
, with residence and postal address at , all
Filipinos, of legal ages, hereby state that we are the nearest living relative of
, a beneficiary of Republic Act No. 11982, who died on
and we hereby appoint as our
true and legal representative to act for and in our name and stead and to receive the Cash Gift amounting
to and Letter of Felicitation (if applicable) for
.

HEREBY GRANTING unto our representative full power and authority to execute and perform every
act necessary to render effective the power granted to him/her, as though we ourselves, have so
performed it, and HEREBY APPROVING ALL that he may do by virtue hereof with full right of substitution of
his person and revocation of this instrument.

IN WITNESS WHEREOF, we have hereunto set our hands this day of 20 , at


.

Name and Signature of Name of Grantor/Principal Name and Signature of

Name and Signature of Name of Grantor/Principal

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES


______________________ S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, this , day of
2024, personally appeared the following individuals:

Name Competent Evidence of Identity Date/Place Issued


____________________________ _________________________ _________________________

known to me to be the same persons who executed the foregoing Special Power of Attorney, consisting of
one (1) page, including the page where this Acknowledgement is written, acknowledged to me that the
same are their free and voluntary act and deed.

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

Doc. No. ;
Page No. ; NOTARY PUBLIC
Book No. ;
Series of 2024.
Annex “C”

Republic of the Philippines


Office of the President
NATIONAL COMMISSION OF SENIOR
4th Floor, AAP Tower, 683 Aurora Blvd, Mariana, 1117 Quezon City,
Philippines Official website: www.ncsc.gov.ph

SPECIAL POWER OF ATTORNEY


(FOR LIVING BENEFICIARY)

KNOW ALL PERSONS BY THESE PRESENTS

I, , years old, Filipino, and with residence and postal address at


, do hereby appoint, name, and constitute
, of legal age, Filipino, and with residence and postal address at
, to be my true and lawful attorney-in-fact, for me and in my name, place, and stead, to do and perform all or
any of the following:
1. To transact, file, apply, process, and follow-up in my behalf the cash gift as provided under Republic
Act No. 11982;
2. To submit all necessary documents in relation to the processing of the said cash gift;
3. To sign, execute, and accomplish pertinent documents in order to give full effect to the foregoing
authority; and
4. To claim/receive the cash gift amounting to amount in words and figures and Letter of Felicitation
(if applicable).

HEREBY GIVING AND GRANTING unto my said attorney-in-fact, full power and authority to do and perform all
and every act and deed requisite or necessary to carry into effect the foregoing authority as fully for all intents
and purposes as I might or could lawfully do if personally present.

HEREBY RATIFYING AND CONFIRMING all that my said attorney-in-factshall do or cause to be done by virtue
of this authority.
This special power of attorney shall be in effect -
□ for month(s);
□ until the completion of the object or purpose above-stated;
□ until revoked.

IN WITNESS WHEREOF, I have hereunto set my hand this day of 20 , at


.

Name and Signature of Name and Signature of Attorney-in-Fact

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
S.S.

BEFORE ME, a Notary Public for and in the above jurisdiction, this , day of 2024,
personally appeared the following individuals:

Name Competent Evidence of Identity Date/Place Issued


____________________________ _________________________ _________________________

known to me to be the same persons who executed the foregoing Special Power of Attorney, consisting of
one (1) page, including the page where this Acknowledgement is written, acknowledged to me that the same are
their free and voluntary act and deed.

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

Doc. No. ;
Page No. ; NOTARY PUBLIC
Book No. ;
Series of 2024.

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