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REPUBLIC OF THE PHILIPPINES )

CITY OF CAGAYAN DE ORO ) S.S.

DEED OF RELEASE AND QUITLAIM


WITH UNDERTAKING

KNOW ALL MEN BY THESE PRESENTS:

I/We:

a. MICHA CHERNOBYL LOPEZ MALANA, of legal age,  single /  married,


Filipino citizen, and with residence address at 054 Upper Zone 2 Bulua,
Cagayan de Oro City, Philippines;

b. _________________________, of legal age,  single /  married, ___________


citizen, and with residence address at
____________________________________________;

c. _________________________, of legal age,  single /  married, ___________


citizen, and with residence address at
____________________________________________; and

d. _________________________, of legal age,  single /  married, ___________


citizen, and with residence address at
____________________________________________;

after having been duly sworn to in accordance with law do hereby depose and say that:

1. I/We am/are the sister and the sole heir(s) of the late MICHAZEL
LOPEZ MALANA (the “deceased”) who passed away on September 17, 2016.

2. The deceased left no other heirs, whether legitimate or


illegitimate,

3. The deceased died intestate, without any Last Will or Testament,


and without any outstanding debts or obligations, whatsoever. No proceeding in court,
testate or intestate, has been filed concerning the property(ies) and/or account(s) herein
described below, which was/were left by the deceased.

4. The deceased left the following property(ies) and/or account(s)


with Metropolitan Bank & Trust Company (METROBANK)-Cebu Capitol Branch:

Account Name Account No. Nature of Account Balance as of


July 24, 2018
Michazel Lopez 330-3-330235919 Savings Php 120,101.07
Malana

5. I/We, as the sole heir(s) of the deceased, settled the deceased’s


estate extrajudicially and adjudicated the above-described property(ies) and/or
account(s) left by the deceased to myself/among ourselves pursuant to and in
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accordance with Section 1 of Rule 74 of the Revised Rules of Court and other applicable
provisions thereof. I/We hereby certify that I/we have complied with all the requirements
provided under Section 1 of Rule 74 of the Revised Rules of Court (the “Rules”) as well
as under all applicable provisions of the said Rules and other laws, rules and regulations
regarding settlement of the estate of the deceased, and that I/we have paid all the taxes
due from the said estate.

6. For and in consideration of the release and/or transfer of the


above-described property(ies) and/or account(s) of the deceased, more particularly the
balance thereof, to me/us, as the sole heir(s) of the deceased, on the basis of and/or
pursuant to the documents which I/we submitted to the METROBANK, I/we hereby
undertake to free and exempt METROBANK, its successors-in-interest, members,
trustees, directors, officers, employees, agents and representatives from any and all
claims, demands, and/or liabilities, of whatever kind or nature, whether past, present or
contingent, in connection with, relative to or arising, wholly or partially, from the release
of the said property(ies) and/or balance in the above-mentioned account(s) of the
deceased with METROBANK- Cebu Capitol Branch. I/We further bind myself/ourselves,
absolutely, unconditionally, and solidarily, to indemnify, reimburse or pay METROBANK,
its successors-in-interest, members, trustees, directors, officers, employees, agents and
representatives, for whatever claims, demands, or liabilities in connection with, relative
to or arising, wholly or partially, from the release of the said property(ies) and/or balance
in the above-mentioned account/s of the deceased.

7. I/We hereby undertake to testify in any court, tribunal, office,


board, bureau, agency or department, for and on behalf and/or in favor of and/or to
defend METROBANK, its successors-in-interest, directors, officers, employees, agents
and representatives, in connection with any and all actions, suits or demands, of any
kind or nature whatsoever, relative to, in connection, directly or indirectly, with or arising,
wholly or partially, from the afore-mentioned property(ies) and/or account/s of the
deceased. As the sole heir(s) of the deceased, I/we also hereby waive the provisions of
the Republic Act No. 1405, otherwise known as “Law on Secrecy of Bank Deposits”,
Republic Act No. 6426, otherwise known as “Foreign Currency Deposit Act of the
Philippines”, Republic Act No. 8791, otherwise known as “The General Banking Law of
2000”, and all other laws, rules and regulations governing the confidentiality of accounts,
funds or properties with Banks, now effective or may, after the execution of this Deed,
become effective; hereby authorize METROBANK, its successors-in-interest, directors,
officers, employees, agents and representatives, to disclose any and all information and
submit any and all records relative to the above-described property(ies) and/or account/s
of the deceased to any court, office, board, bureau, tribunal, agency, entity or person,
including but not limited to the Bangko Sentral ng Pilipinas; and hereby release, remise,
and forever discharge METROBANK, its successors-in-interest, directors, officers,
employees, agents and representatives, from any claims or liabilities arising from or in
connection with such disclosure.

8. I/We am/are executing this Deed of Release and Quitclaim with


Undertaking to attest to the truth and veracity of the foregoing.

9. I/We hereby finally attest that I/we have read and fully understand
this Deed of Release and Quitclaim with Undertaking as well as the legal implications
thereof, and that I/we hereby express my/our complete agreement and conformity
thereto willingly, voluntarily, without reservation on my/our part and with full knowledge of
my/our rights under the law.

IN WITNESS WHEREOF, I/we hereunto set my/our hand(s) this ___th day of
____________ 20__ at ________________, Philippines.
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MICHA CHERNOBYL LOPEZ MALANA ________________________


(Signature over Printed Name) (Signature over Printed Name)

________________________ ________________________
(Signature over Printed Name) (Signature over Printed Name)

Signed in the presence of:

____________________________ _____________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


CITY OF CAGAYAN DE ORO )

BEFORE ME, a Notary Public for and in the City of Cagayan de Oro personally
appeared:

Competent Evidence
of Identity No.
Place and Date of Issuance;
Name (i.e. Passport/Driver’s
Date of Expiration
License No./
SSS ID etc.)
Micha Chernobyl Lopez Malana Passport No. P3186630A DFA DUMAGUETE/Valid Until
25 May 2022

known to me and to me Deed of Release and Quitclaim with Undertaking and they
acknowledged to me that the same is his/her/their free and voluntary act and deed.

The said Deed of Release and Quitclaim with Undertaking consists of three (3) pages
including this page on which the acknowledgment is written, duly signed by the party(ies) and
his/her/their instrumental witnesses on each and every page hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this __________________ at


Cagayan de Oro City, Philippines.

Doc. No._ ;
Page No. _ ;
Book No. _ ;
Series of 2018.

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