SPECIFIC POWER OF ATTORNEY I, THE UNDERSIGNED: Name: [Full Name as per Passport] Date of Birth: [DD/MM/YYYY] Nationality: Georgian Passport No.: [Passport Number] IRP Number: [IRP Registration Number, if applicable] Residing at: [Current Address, Eircode, Ireland] HEREBY APPOINT AND CONSTITUTE: Name: [Attorney / Solicitor Full Name] Profession: [Solicitor / Representative] Office / Address: [Law Firm / Address, Eircode, Ireland] Law Society No. (if solicitor): [Solicitor Number] as my true and lawful Attorney for me and in my name, place, and stead, to do all or any of the following acts and deeds: 1. To act on my behalf before the Department of Justice, Immigration Service Delivery (ISD), and the Garda National Immigration Bureau (GNIB). 2. To lodge, amend, withdraw, and track applications, submit documentary evidence, and receive all correspondence and decisions. 3. To represent me before the Revenue Commissioners, Department of Social Protection, and other public bodies of Ireland. 4. To sign on my behalf any declarations, appeals, or legal documents reasonably required for the regularisation of my affairs. This Power of Attorney shall remain valid until [Expiry Date, e.g. 31st December 2026] or until revoked by me in writing. IN WITNESS WHEREOF I have executed this document this [Day] day of [Month], [Year]. SIGNED, SEALED AND DELIVERED by the Principal: ____________________________________ [Principal Signature] IN THE PRESENCE OF (Witness - Solicitor / Notary Public): Witness Name: ____________________________________ Qualification: [Practising Solicitor / Notary Public] Address: _________________________________________ Signature: _______________________________________