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Republic of the Philippines)

City of Dumaguete ) S. S.
X---------------------------------X

WAIVER OF RIGHTS

I, MC KENNY P. CABIGAS, Filipino, of legal age, single, and with residence and post office address at
Zone 3 Cangmating, Sibulan, Negros Oriental Philippines, after having been first duly sworn to in
accordance with law, do hereby depose and say:

1) That I am the beneficiary of St. Peter Life Plan Policy Contract


No.MV126051 owned by my deceased father "DOMINGO B.
CABIGAS";

2) That I hereby waived all my rights, claims, and interests as the beneficiary of S t . P e t e r
Life Plan Policy Contract No.MV126051;

3) That I hereby declare that I have fully read and understood the contents of this document
and that this Waiver of rights, is made freely and voluntarily, with full knowledge of my rights
under the law.

4) As such, I execute this Affidavit to attest to the truth of the foregoing facts, and for
whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set m y hand this_____________________. In the


City of Dumaguete.

MC KENNY P. CABIGAS
Conforme:

Signed in the presence of:

1. ________________________________ 2.____________________________

ACKNOWLEDGMENT:

REPUBLIC OF THE PHILIPPINES)


CITY OF DUMAGUETE ) S.S
X- - - - - - - - - - - - - - - - - - - - - - /

BEFORE ME this ___________________, in the City of Dumaguete, Philippines, personally appeared


MC KENNY P. CABIGAS with Driver's License No. _______________, known to me as the same person
who executed the foregoing instrument and acknowledged to me that the same is his own free voluntary
act and deed.

WITNESS MY HAND AND NOTARIAL SEAL on the date and place first above written.

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