REPUBLIC OF THE PHILIPPINES )

) S.S.

AFFIDAVIT OF WAIVER AND QUITCLAIM

I, _________________, Filipino, of legal age, single/married and a resident of

__________________________________________________, after having been sworn in accordance with law,
hereby depose and state that:

1. I am an employee of GEMAR INTERNATIONAL PHILIPPINES CORPORATION with business

address at Unit 505&503, 5F, Lasema Bldg.8864, Sampaloc St. cor. Estrella St., San Antonio Village,
Makati City.

2. I have filed my voluntary resignation with the Company effective on _____________________,

attaching hereto as Annex “A” is a copy of my resignation letter.

3. Upon proper computation by the Company’s Finance Department, I am to receive the amount of
___________________________________ (P ____________) as final and full settlement of all such
salaries and employment benefits in accordance with the pertinent employment contract provisions and
labor laws.

4. I hereby acknowledge receipt of the sum of __________________________ (Php _________),

Philippine currency, representing full satisfaction of all my remaining salaries and employment benefits
and as a further manifestation of the Gemar’s goodwill towards me and for my benefit.

5. Furthermore, I voluntarily and freely acknowledge that I have no claims or right of action, whether
past, present, future or contingent, of whatever nature against GEMAR INTERNATIONAL
PHILIPPINES CORPORATION., and any affiliated companies, its officers, that may arise relative
to my employment with the company, acknowledging further that I had been duly paid all my salaries,
emoluments, legal benefits and the like during the existence of my employer-employee relationship
with the company and the termination of such relationship in view of my voluntary resignation from
the company.

6. I hereby also voluntarily, freely and unconditionally waive any and all such claims, if any, and in
executing this waiver and quitclaim, I have fully renounce any claims or right of action of whatever
nature, whether past, present, future or contingent against said corporation and its officers, relative to
my employer-employee relationship with the company and the termination of such relationship in view
of my voluntary retirement from the company.

7. I affirm that I was not forced into resignation and I further affirm and confirm my resignation from the
company effective _______________.

8. I fully understand the statements I have made in this document that has been explained to me in a
dialect/language I understand. I have affixed my signature hereunder voluntarily and freely with full
and complete knowledge of the meaning and intent of this document and of my rights under existing
laws.

9. I acknowledge further that any future work or service that I may provide the company shall be on a
contractual basis, as my regular employment with the company had been extinguished in view of my
resignation from the company.

AFFIANT FURTHER SAYETH NAUGHT.

Unit 503 & 505, 5F, Lasema Bldg. 8864, Sampaloc St. cor. Estrella St., San Antonio Village, Makati City Philippines
www.gemar.com.ph (02) 5290262 0917-1804168 / 0917-1804188
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _________ 200__ at
_________________________________, Philippines.

__________________
Affiant

Conforme:

______________________________________

HR & ADMIN OFFICER

BEFORE ME, a Notary Public, for and in _________________, Metro Manila, this ____ day of
______________________, personally appeared ____________________ with his/her CTC No.
____________________ issued at _____________ on ______________, known to be and to me known to be
the same person who executed the foregoing Affidavit of Waiver and Quitclaim and acknowledged to me that
the same is his/her free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and place first herein above stated.

NOTARY PUBLIC

Doc. No.

Page No.

Book No.

Series of 20__.

Unit 503 & 505, 5F, Lasema Bldg. 8864, Sampaloc St. cor. Estrella St., San Antonio Village, Makati City Philippines
www.gemar.com.ph (02) 5290262 0917-1804168 / 0917-1804188