Republic of the Philippines)

______________________ ) S.S.

AFFIDAVIT OF SEPARATION FROM EMPLOYMENT

I, Abigail Joy H. Ong, of legal age, Filipino, and with office address at
____________________________________, after having been duly sworn in
accordance with law depose and say that:

1. I am the HR & Admin Head of Hexagon Healthcare Corporation, a

corporation duly organized and existing under and by virtue of the laws of
the Republic of the Philippines and with office address at
___________________________________________ and the authorized
representative of said corporation in the execution of this affidavit.

2. I hereby certify that ________________,___________________, and

_______________________ are already separated from employment with
Hexagon Healthcare Corporation. The following are the details of
employment of the aforesaid employees.

3. I am executing this affidavit to attest to the truth of all the foregoing facts
and for the purpose of complying with the requirements of SSS for
whatever use or purpose this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ th day of

September 2016 in Quezon City, Philippines.

Abigail Joy H. Ong

Affiant

SUBSCRIBED AND SWORN TO before me this _____ day of September

2016, affiant exhibiting to me her TIN ID with No._____________________.

Doc. No. ____; Notary Public

Page No. ____;
Book No.____;
Series of 2016.