SPA To Release and Negotiate Check

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SPECIAL POWER OF ATTORNEY

(Request for Release and Negotiate the Check)

KNOW ALL MEN BY THESE PRESENTS:


I, _____________________, of legal age, Filipino with residence and postal address at
__________________________________________________, NAME, CONSTITUTE and
APPOINT, _____________________, of legal age, Filipino 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 the following acts and things, to wit:

1. To inquire about my CAP Educational Plan under Scholarship Funding Agreement No.
___________________, particularly if there is a check for me to claim and when it will be
available for claiming:

2. To fill out sign on the Request for Release of Check in my behalf and attach the required
documents to this Request for Release of Check;

3. To sign any voucher, acknowledgment receipt or form or any such document/s required
for the release of the check;

4. To endorse, deposit or encash the check and receive the proceeds of the check.

HEREBY GIVING AND GRANTING unto my Attorney-In-Fact full power and authority to do
and perform all and every act and thing whatever 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, with all
power of substitution and revocation, and hereby ratifying and confirming all that my said Attorney-
In-Fact shall lawfully do or cause to be done by virtue thereof. The foregoing powers and authority
given shall be effective immediately until the same is expressly revoked or cancelled.

IN WITNESS WHEREOF, I hereby affix my signature this ______ day of __________, 2022
at Makati City.

______________________
Subscriber ________________________
Attorney-In-Fact

Signed in the presence of:

_________________________ _____________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES }


} S.S.

BEFORE ME, a Notary Public for and in ____________, This ____ day of _________, 2022,
personally appeared ______________________ with his/her valid identification card.
_________________________, 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 free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date at the place first above-written.

Doc. No.______;
Page No.______;
Book No._______;
Series of 2022.
*************

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