SPECIAL POWER OF ATTORNEY

I, BENSALI OMARALI, hereby name, appoint and constitute, HADJA ATIKA DEGUSMAN, to be
my true and lawful attorney in fact, to act on my behalf and in my name, to execute and perform all or
any of the following acts, deeds, matters and things, in connection with claiming my renewed passport
with the Department of Foreign Affairs to wit:
IN WITNESS WHEREOF, the Parties have hereunto set their hands on this __ day of ______
2013 in the City of Zamboanga, Philippines.
1. To receive and claim, in my behalf, my renewed passport with the Department of Foreign
Affairs;
2. To negotiate and communicate with the Department of Foreign Affairs as to the release of my
renewed passport, to make, sign and execute the documents that may be required thereof
pursuant to the release of the passport;
3. To file the criminal and civil complaints before the appropriate courts, administrative or other
government agencies, including Barangay conciliation proceedings, against person in
connection with the claim of benefits;
4. To appear on behalf of us in any court or administrative proceedings (including Barangay
conciliation) thereof, with full powers and authority to consider and enter into an amicable
settlement, to submit to alternative modes of dispute resolution, to enter into stipulations and
admissions of fact and of documents and such other matters as may aid in the prompt
disposition of the action; and
5. To perform all other acts necessary to carry out the foregoing purposes.
HEREBY GIVING AND GRANTING unto out Attorney-in-Fact full power and authority to do
and perform all and every act and thing whatsoever requisite, necessary or proper to be done and about
the premises as fully to all intents and purposes as we might or could do if personally present, and
acting in person; and
HEREBY RATIFYINH AND CONFIRMING all that our said Attorney-in-fact shall lawfully do
or cause to be done under and by virtue of these presents.
IN WITNESS WHEREOF, the Parties have hereunto set their hands on this __ day of ______ 2014 in
the City of Zamboanga, Philippines
BENSALI OMARALI
Principal
Signed in the Presence of
_________________

_________________

ACKNOWLEDGEMENT
Republic of the Philippines)
Zamboanga City...)S.S.
x-------------x
BEFORE ME, this __ day of ______, 2014 in the Zamboanga City, Philippines, personally appeared BENSALI
OMARALI, with ___________ with number _______________ issued at______ on ________ known to me
and to me known to be the same person who executed the foregoing Special Power of Attorney consisting of one
page and he acknowledged to me that the same is his free act and deed.
IN WITNESS WHEREOF, I have placed my hand and seal on the date and at the place first above-written.
Doc. No.:
Page No.:
Book No.:
Series of _____.