SPECIAL-POWER-OF-ATTORNEY-TRAVEL-MINOR-TO-AUNT Final

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SPECIAL POWER OF ATTORNEY

I Raymond Siongco Blanca single, of legal age with residence and


postal address at Area 4 C #20 Sta. Cecilia Maly San Mateo Rizal ,do hereby
APPOINT as my true and lawful attorney-in-fact , Shiela Marie Blanca Luching
married, of legal age , with residence and postal address at L4 Ilang Ilang St
Torres Subdivision Brgy San Jose Rodriguez Rizal for me and in my name ,
place and in my behalf , and to do and perform all of the following
responsibilities and to have all the rights in connection of the following:

1. That I am the father of the child named below


Name : RAYMOND CATIPAY BLANCA
Date of Birth : APRIL 24, 2014
Place of Birth : SAN MATEO RIZAL
2. That it is my desire for the said child to travel ;
3. That the said minor will be accompanied by Shiela Marie Blanca
Luching his aunt;
4. To APPLY for the DSWD travel Clearance of the above mentioned child
5. To SIGN, EXECUTE, and ACKNOWLEDGE all pertaining papers and
documents in relation thereto
6. To represent , transact and process all documents at any government
offices
7. Inquire, obtain information, and receive documents and records from
government agencies including DSWD, courts, and other agencies
with personal information and government information.
8. I am willing and able to support my child during the said travel;
9. To perform and act as and for me in a personal capacity to the above
mentioned child;
10. Though the father/mother of said child/children is not here present, I
am giving consent to the above acts in as much as: said father/mother
has earlier voluntarily and freely given his/her consent, with no
condition imposed whatsoever, and requested that said consent be
relayed by me.
11. . I assume responsibility for the issuance of the passport and for
allowing the trip of the said minor and further assume all obligations
consequent thereto; and
12. I am executing this Affidavit to attest to the truth of the above
statements and for whatever legal purpose this may serve.

I grant the authorized representative/s full power and authority to perform


any and every act and thing whatsoever requisite or necessary or proper to be
done as fully to all intents and purposes as I could lawfully do if personally
present, with power of substitution and revocation.
IN WITNESS WHEREOF, I execute this instrument this __ day of
__________ in ____________. _____________________ Republic of the
Philippines) ____________ ) S.S.

ACKNOWLEDGMENT
BEFORE ME, a Notary Public for Makati City appeared the following this
day of_________________ the above affiant presenting the following
government ID: ___________ with ID number _______________. IN

WITNESS WHEREOF, I have hereunto set my hands on the date and


place above written.

Doc No. _____.


Page No. ____.
Book No. ____.
Series of 20___.

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