SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, ___________________, of legal age, Filipino and with residential address at

___________________________________________________, do hereby constitute, name
and appoint _____________________ 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 deeds:

1. To represent me as Complainant in the hearings and other stages of the proceedings in

NLRC (case number) filed against ______________________ before the National
Labor and Relations Commission of Quezon City, and for this purpose to appear in
my behalf during the mandatory conferences with the Labor Arbiter, answer, oppose
all actions and proceedings that may have any connection with the aforementioned
case;
2. To enter into an amicable settlement, to submit to alternative modes of dispute
resolution, and to enter into stipulations or admissions of facts and of documents;
3. To sign and execute any and all documents and/or papers necessary or that may be
required in connection with the powers herein granted.

HEREBY GIVING AND GRANTING unto my said attorney full power and
authority whatsoever requisite or necessary or proper as I might or could lawfully do if
personally present.

HEREBY RATIFYING AND CONFIRMING all that my said attorney shall do or

cause to be done under and by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand on this ______ day of April
2019 at Pasig City.

_____________________________________

SIGNED IN THE PRESENCE OF:

__________________________ ___________________________

REPUBLIC OF THE PHILIPPINES)

PASIG CITY ) S.S.

BEFORE ME, a Notary Public for and in Pasig City on this ___ day of April 2019 at
Pasig City personally appeared _______________, exhibiting to me her ________________
with ID Number _____________, who is known to me to be the same person who executed
the foregoing instrument and acknowledged to me that the same is her free and voluntary act
and deed.

Doc. No._____
Page No._____
Book No. _____
Series of 2019.