WAIVER OF CLAIMS AND RIGHTS

KNOW ALL MEN BY THESE PRESENTS:

I, _______, of legal age, (single or married) and a resident of __________City, do by

these presents, agree and acknowledge that as a customer of service repair in SENDAI MOTORS
Inc., I allow the latter to pick up my service unit and have it transported to their service repair
area. As such, any liability on the part of the Company which may arise out from the transport of
said service unit, I hereby release, discharge and waive by reason of the same.

I declare that I have read this document and have fully understood its contents. I further
declare that I voluntarily and willingly executed this Waiver of Claims and Rights with full
knowledge of my rights under the law and with our existing Contract.

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

_______________, 20__, at ____________, Philippines.

____________________

Affiant
Signed in the presence of:

_______________________ ______________________

ACKNOWLEDGMENT

Republic of the Philippines

(____________________)

Before me, a Notary Public of ____________, Affiant personally appeared known to me

and to me known to be the same person who executed the foregoing document and he
acknowledged that the same is his free and voluntary act and deed.

NAME I.D. PRESENTED

_____________________ ____________________

Doc. No. _____________

Page No. _____________
Book No. _____________
Series of _____________