SPA-Tourist Visa Extension - Sample

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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________, of legal age, Japanese, with residential address at West Cebu


Industrial Park-Special Economic Zone, Buanoy, Balamban, Cebu, Philippines do hereby name,
constitute and appoint Ms. ____________________, with office address at
__________________________________, Cebu, Philippines, to be my true and lawful attorney,
in my name, place and stead, to file, process, and secure my Tourist visa extension from the
Bureau of Immigration – Cebu Office.

HEREBY GIVING AND GRANTING unto the said attorney full power and authority to
do and perform all and every act requisite or necessary to carry into effect the foregoing authority,
as fully to all intent and purposes as I might or could lawfully do, with full power of substitution
and revocation, and hereby ratifying and confirming all that the said attorney or his authorized
representative shall lawfully do or caused to be done by virtue hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ at


Balamban, Cebu, Philippines.

___________________
Principal

Signed in the presence of:

________________________ _________________________
Name of Witness Name of Witness

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


CITY OF LAPULAPU ) S. S.

BEFORE ME, a Notary Public for and in Cebu City, Philippines this_____________ at
Lapu-Lapu City, Philippines, appeared ___________________ with Passport No.
___________________, personally known to me and to me known to be the same person who
executed the foregoing Special Power of Attorney and he acknowledged to me that the same is his
free and voluntary act and deed.

WITNESS MY HAND and NOTARIAL SEAL on the day and at the place first above
written.

Doc No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

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