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06 SPA Complaint

HLURB special power of attorney complaint

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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:
I,

of

legal

age,

(nationality),

with

residence

at

----------------------~' do hereby
appoint, name and constitute
, likewise of legal age, single/married, with
residence at
, who is related to me and/or is my next-of-kin,
and is not a lawyer, as my true and legal representative to do and perform the following acts and deeds:
To file and institute the complaint (or answer) for and in my name, place and stead, and to execute such
other papers to give full effect to the said complaint (or answer), including the verification and certification
against form shopping;
To act for and in my name, place and stead and to represent me during the Mandatory Conference with
full authority to enter into amicable settlement under such terms and conditions as may be acceptable to
him/her, to submit to alternative modes of dispute resolution and to make admissions or stipulations of
facts and documents without further consultation from me.
To file an appeal or any other petition to protect my interests and likewise with full power and authority to
do and execute such deeds, documents and things as may be proper and necessary to advance the said
interest.
I hereby grant my representative full power and authority to execute and perform every act necessary to
render effective the powers herein provided as though I myself have so performed it and hereby
approving all that he may do by virtue of these presents.
In witness whereof, I hereunto set my hand this _ _ _ _ _ day of _ _ _ _ _ _ , 20.___ , at

Complainant/Respondent

Representative

Witness

Witness

REPUBLIC OF THE PHILIPPINES )
_ _ _ _ _ _ _ _ _ _ _ _ __,S.S.
BEFORE ME, a Notary Public for and in
, Philippines, personally
appeared
, with
issued at
on
, known to me and to me known to be the same person who
executed the foregoing special power of attorney and he/she acknowledged to me that the same is his/her
voluntary act and deed.

----------

IN WITNESS WHEREOF, I have affixed my signature and seal on the date and place first abovewritten.
Doc.No. _ __
Page No. _ __
Book No. _ __
Series of _ __

Notary Public
 
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