WAIVER OF RIGHTS

KNOW ALL MEN BY THESE PRESENTS:

I, MELODY MALIG ON CABURAL, of legal age, Filipino, and a resident of

Block 5, Lot 12, Phase 8, Dasma 3, Golden City, Salawag, City of Dasmarinas,
Cavite, after having been sworn to in accordance with law, depose and state:

1. That I am the holder and payee of Banco de Oro check with check
number 0000401955 dated February 18, 2016 bearing an amount of
Eleven Thousand Seven Hundred Forty Seven Pesos & 29/100
(Php11,747.29) issued by Paramount Life & General Insurance Corp.;

2. That for the reason that I am working abroad or OFW, I hereby waive
all my RIGHTS, INTERESTS and PARTICIPATION over the said check
in favor of my sister, MARY NAN CABURAL TUSI;

3. Thus, I hereby request Paramount Life & General Insurance Corp. to

re-issue a check in favor of my sister, MARY NAN CABURAL TUSI;

4. That I hereby declare that I have read this document and fully
understood its contents;

5.

6. That I execute this Waiver, freely and voluntarily to attest to the

foregoing facts and statements and for whatever legal purposes and
intents the same may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day of August,

2019 in the Province of Cavite.

MELODY MALIG ON CABURAL

Affiant

With my Conformity:

MARY NAN CABURAL TUSI

SUBSCRIBED AND SWORN BEFORE ME this 27 th day of August, 2019 in the

Province of Cavite, affiant exhibiting her Competent Evidence of Identity
consisting of SSS ID Card bearing number 33-3059924-6.

Doc No. __________ NOTARY PUBLIC

Page No. __________
Book No. __________
Series of 2019