SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS: I, _____________________________________, of legal age, Filipino citizen, single/married, with postal address at _______________________________________, do hereby name, constitute and appoint our CASHIER, MS. JOVEE C TUMANDAO, of legal age, Filipino citizen, single, with postal address at 145 Union Square Condominium, 15th Avenue, Cubao, Quezon City, as my true and lawful attorney-in-fact, for me and my name, place and stead, to do and perform the following act, to wit: 1. To get secure, and sign, in my behalf my monthly salary Continuous Form Check (CFC) at Finance Service unit (FSU), Bureau of Fire Protection, National Headquarters, 145 Union Square Condominium, 15th Avenue, Cubao, Quezon City, for the period from _______to______and to encash the same check. 2. That failure of the FSU or any of its branches to deduct my monthly contributions, loan payments and other deductions due for FSMBAI, latter (FSMBAI) or its duly authorized representative shall receive and/or secure my continuous form check so as to effect the necessary deduction of my monthly contributions, loans, loanpayments and other deductions due for FSMBAI. HEREBY GIVING AND GRANTING unto my said Attorney-in-Fact full power and authority to do or cause to be done as I might lawfully do or cause to be done in about the premises as fully and for all intents and purposes as I might or could lawfully do if personally present and act in person. That I hereby REVOKE, ANNUL and make VOID, any Special Power of Attorney previously issued for the same purpose aforementioned. IN WITNESS WHEREOF, I have hereunto set my hands this ________day of _____________________ 20___, at Quezon City, Philippines.

________________________________________________

Principal

SIGNED IN THE PRESENCE OF: 1.________________________________ 2.________________________________

ACKNOWLEDGEMENT Republic of the Philippines )

Quezon City, Metro Manila ) s.s.

BEFORE ME, Notary Public of Quezon City, Metro Manila, this ________ day of _______________ 20____, personally appeared with Comm. Tax Cert. No. _______________ issued at _______________________ on _____________, known to me be the same person who executed the foregoing instrument and acknowledged to me that the same is his/her free and voluntary deed. WITNESS MY HAND AND SEAL, the day and place above written. Doc. No. _________; Page No. _________; Book No. ________; Series of 201__.

PROXY
KNOW ALL MEN BY THESE PRESENTS: THAT I, undersigned a bonafide member of Fire Services Mutual Benefit Association, Inc., do hereby name constitute and appoint Mr./Ms. ______________________________, to be my true and lawful ATTORNEY-IN-FACT and PROXY, to attend all meetings of members of said Association, regular or special particularly, but not limited to the scheduled meeting on _______________, 20____and thereat to represent me and in my name, place and stead, to vote any and all number of votes now standing or which may thereafter stand in the Books of the Association in my name, on all questions and matters whatsoever that may be taken up during those said meetings, and to do all other things competent and proper, such as in his judgment may be necessary or advantageous, and all powers belongings to or pertaining to me as member of said Association, hereby confirming all that said ATTORNEY-IN-FACT and PROXY may lawfully do in my name, place and stead. This proxy shall continue until such time as the same is withdrawn by me through notice in writing addressed and delivered to the Secretary of the Association. _______________________ (Signature of Proxy)
_______________________

__________________________ (Signature of Member) __________________________ (Printed Name of Member) __________________________ (Mailing Address of Member) SIGNED IN THE PRESENCE OF:

(Printed Name of Proxy) (Date Signed)

_______________________

1.________________________________

2.________________________________

ACKNOWLEDGEMENT Republic of the Philippines ) Quezon City, Metro Manila ) s.s. BEFORE ME, a Notary Public for and in _______________________, personally Appeared the following: Name 1. 2.
Both known to me and to me known to be the same person who acknowledged to me that the same is their free acts and voluntary deeds. WITNESS MY HAND AND SEAL, _________________________, Philippines. Doc. No. _________; Page No. _________; Book No. ________; Series of 201__. this _____day of _______________ 201__, at

Comm. Tax Cert. No.

Date/ Place Issued