Special Power Of Attorney printable pdf download

The Insular Life Assurance Company, Ltd.

Insular Life Corporate Centre, Insular Life Drive

Filinvest Corporate City, Alabang, 1781 Muntinlupa City

E-mail: .ph • Website:

Tel.: (632) 582-1818 • Fax: (632) 771-1717 • TIN 000-464-124 Non-VAT

Special Power o

Special Power of Attorney

f Attorney

KNOW ALL MEN BY THESE PRESENTS:

I/We, __________________________________________________, of legal age, Filipino,

single

[or

married

_________________________________________],

have named, constituted and appointed, and by these presents, do hereby name,

constitute and appoint _______________________________, also of legal age, Filipino,

single/married, to be my/our true and lawful Attorney-in-Fact for me/us and in my/our

name, place and stead, and for my/our own use and benefit, to do and perform all or any of

the following acts and things, namely:

To file with The Insular Life Assurance Company, Ltd. (“Insular Life”), in

my/our behalf, application for

maturity benefit

survivorship benefit

others:

⁮

death benefit

loan

______________________

under Insular Life’s _________________________________, issued on the life of

[type of plan]

________________________________with Policy Number ____________________

[name of insured]

issued on _________________ and to comply with all the relevant processing

[effective date]

requirements of Insular Life for the purpose;

2. To receive from Insular Life in my behalf, the corresponding check representing

payment of the ___________________ proceeds under Policy No

Policy No. ______________;

Policy No

3. To execute and sign any and all the necessary agreements, documents and

other legal papers pertaining to the above powers to give effect to the foregoing

authority.

HEREBY GIVING AND GRANTING

HEREBY GIVING AND

GRANTING unto said attorney-in-fact full powers and

HEREBY GIVING AND

GRANTING

authority to do and perform all and every act and things whatsoever requisite and

necessary to carry into effect the foregoing authority, as fully to all intents and purposes

as I/we might or could lawfully do if personally present, and hereby ratifying and

confirming all that my/our said attorney-in-fact shall lawfully do or cause to be done by

virtue of these presents.

I/We, upon receipt by my/our Attorney-in-Fact of the check representing the

payment of _______________ proceeds under Policy No.

Policy No. ___________ from Insular Life, do

Policy No.

hereby release and discharge Insular Life, its officers, employees, agents, and other

personnel from any and all claims, demands or liabilities of whatever nature and kind in

connection with or arising out of all the incidents related or in connection with the above

insurance policy transaction and forever warrant and defend the aforesaid payment, and

save harmless Insular Life from any and all other claimants.

IN WITNESS WHEREOF

IN WITNESS WHEREOF, I/we have hereunto set my/our hand this _______ day of

IN WITNESS WHEREOF

_____________________, 20__, in the City of ___________________________.

Special Power Of Attorney

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