RELEASE WAIVER AND QUITCLAIM

KNOW ALL MEN BY THESE PRESENTS:

That I, Graciano Florido y Realo, Filipino, of legal age,

and resident of Blk-7, Lot 21, Ferrari Road, Luxury Villa. Brgy.
San Isidro, Angono, Rizal,, do by these presents acknowledge and
express my deepest gratitude to the present employer of Ruben
Memoria Y Gardose or anyone acting on his behalf for the financial
consideration in the amount of _________________Philippine Currency,
in full payment and final settlement of all my claims of whatever kind
and nature which I have or may have against Ruben Memoria Y
Gardose, arising from my injuries as a result of a vehicular accident
which transpired on October 14, 2018 at Ortigas Ave. Extention, Brgy.
Dolores, Taytay, Rizal to which Ruben Memoria Y Gardose, is not at
fault and completely free of any liability as the said incident is purely
an accident and unintentional arising from circumstances that Ruben
Memoria Y Gardose, has no control or influence whatsoever.

In consideration of said financial assistance, I do hereby

quitclaim, release, discharge and waive any and all actions of
whatever nature, expected, real or apparent, which I may have
against Ruben Memoria Y Gardose, by reason of or arising from
my injuries. I will institute no action, whether civil, criminal or
administrative against Ruben Memoria Y Gardose,. Any and all
actions which I may have commenced either solely in my name or
jointly with others before any office, board, bureau, court, or tribunal
against Ruben Memoria Y Gardose, are hereby deemed and
considered voluntary withdrawn by me and I will no longer testify or
continue to prosecute said action(s).

I declare that I have read this document and have fully

understood its contents. I further declare that I voluntarily and
willingly executed this Release, Waiver and Quitclaim with full
knowledge of my rights under the law.

IN WITNESS WHEREOF, I have hereunto set my hand at Taytay, Rizal

this __ day of October, 2018.

Graciano Florido y Realo

Affiant

SIGNED IN THE PRESENCE OF

_______________________ ______________________
 SUBSCRIBED AND SWORN TO before me this ___ day of
Ocrober 2018 hereat Taytay Rizal, affiant exhibiting to me his
____________________________.

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