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Special Power of Attorney: Passport No.: Issued On Issued in With My Conformity

This document appoints NAME as attorney-in-fact to process and receive the proceeds of an insurance claim on behalf of the author. It grants NAME the authority to (1) process the insurance claim, (2) receive proceeds in check or cash, (3) cash or deposit any checks, and (4) sign documents related to effecting the stated powers. The author ratifies all actions taken by NAME under this power of attorney.

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Kaizer Dave
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84 views

Special Power of Attorney: Passport No.: Issued On Issued in With My Conformity

This document appoints NAME as attorney-in-fact to process and receive the proceeds of an insurance claim on behalf of the author. It grants NAME the authority to (1) process the insurance claim, (2) receive proceeds in check or cash, (3) cash or deposit any checks, and (4) sign documents related to effecting the stated powers. The author ratifies all actions taken by NAME under this power of attorney.

Uploaded by

Kaizer Dave
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, , of legal age, Filipino citizen, and a resident of City,


Philippines, hereby NAME, CONSTITUTE, and APPOINT my,
likewise of legal age, Filipino Citizen, presently residing at City,
Philippines to be my true and lawful attorney-in-fact for me and in
my name, place, and stead, to perform any and all of the following
acts, to wit:

1. To process and transact with the, Incorporated, for and in


my behalf with regard the insurance claim of;

2. To receive the proceeds of the insurance, in check or in


cash for and in my behalf;

3. In case of check, to encash or deposit the same as she


deems necessary;

4. To sign, execute, receive and/or deliver contracts and


agreements, other papers and/or money to effect with her
power stated in this authorization pertinent to the above
described authority.

HEREBY GIVING AND GRANTING unto my said attorney in


fact full power and authority to do and perform all and every act and
thing whatsoever requisite and necessary to be done in and about the
premises, as fully, to all intents and purposes, as I might or could do if
personally present and hereby ratifying and confirming all that my
said attorney in fact shall lawfully do or cause to be done by virtue
thereof.

IN WITNESS WHEREOF, I have hereunto set my hand this 16 th


day of October 2018.

_____________________
Passport No.:
Issued on
Issued in
With my conformity:

_______________________
Republic of the Philippines )
) S.S.
Done in the City of )

ACKNOWLEDGEMENT

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