REPUBLIC OF THE PHILIPPINES )

)S.S.

WAIVER OF RIGHTS

I, ARNEL COLLADO FLORES THE UNDERSIGNED, APNP RETIREE/

PENSIONER AND RESIDENT AT BRGY. PULOT CENTER, SOFRONIO
ESPANOLA, PALAWAN HAS AFFIXED MY SIGNATURE TO WAIVE MY RIGHTS ALL
EXISTING RULES AND REGULATIONS AS A DEPOSITOR OF THE LANDBANK
PUERTO PRINCESA WEST BRANCH LOCATED AT BRGY SAN MANUEL, PUERTO
PRINCESA CITY, PALAWAN UNDER PENSION SAVING ACCOUNT NO.
______________________.

AUTHORITY IS LIKEWISE GIVEN TO THE CHIEF, PHILIPPINE NATIONAL

POLICE (PNP) OR HIS DULY AUTHORIZED REPRESENTATIVE AS A THIRD PARTY
TO MEDIATE MAKE NY/ ALL ADJUSTMENT, CORRECTION OR STOPPAGE OF
PAYMENT ON MY ACCOUNT AS WELL AS TO MAKE ANY INQUIRY/ PROBE ON THE
STATUS ON MY ACCOUNT WITH YOU.

THE UNDERSIGNED HOLDS LANDBANK FREE AND HARMLESS FROM ANY

LIABILITY AND/OR DAMAGE ARISING OUT OF NOTICE, ADVICE OF INSTRUCTION
FROM PNP POLICE DIRECTOR GENERAL OR HIS DULY AUTHORIZED
REPRESENTATIVE IN CONNECTION WITH PNP PENSION ATM SAVINGS ACCOUNT
INCLUDING INSTRUCTION TO HOLD/ OR SUSPEND AND WITHDRAW THEREFROM
OR REVERSE AND CREDIT ENTRY AND WAIVE ANY RIGHTS OR BENEFITS
ACCORDED BY REPUBLIC ACT (R.A.) NO. 1405 OR ANY SIMILAR LAW, RULES
AND REGULATION IN RELATION TO SAID NOTICE, ADVICE OR INSTRUCTIONS.

Arnel C. Flores
(Signature of affiant over Printed name)

_____________________ _____________________
(witness) (witness)

Subscribed and sworn to before me this ___________________, showing

AFFIANT before the undersigned his/her Community Tax Number:
________________ issued at ______________on _______________________.