MUTUAL RELEASE WAIVER AND QUITCLAIM

KNOW ALL MEN BY THESE PRESENTS:

            That I, ___________________, of legal age, Filipino,

married/single and a resident of __________________, by these
presents acknowledge receipt of the sum ______ THOUSAND PESOS
(PHP 00,000.00), Philippine Currency, from
___________________________, of legal age, Filipino, married and a
resident of _____________________________ in full payment and final
settlement of whatever damages caused as a result of the collision
between the motorcycle and the latter’s PUJ motor vehicle on
February ____, 2019 in ____________ll as any and all claims of
whatever kind and nature which I have or may have against
______________________________, arising from the said Promissory Note
and Amended Compromise Agreement.

            In consideration of said payment, We <NAME> and <NAME>

do hereby quitclaim, release, discharge and waive any and all actions
of whatever nature, expected, real or apparent, which we may have
against each other, by reason of or arising from the Promissory Note
and Amended Compromise Agreement. 

We will institute no action, whether civil, criminal, labor or

administrative against each other.  Any and all actions which we may
have commenced either solely in my name or jointly with others before
any office, board, bureau, court, or tribunal against each other are
hereby deemed and considered voluntary withdrawn by me and we
will no longer testify or continue to prosecute said action(s).

            We declare that we have read this document and have fully
understood its contents.  We further declare that we voluntarily and
willingly executed this Release, Waiver and Quitclaim with full
knowledge of my rights under the law.

IN WITNESS WHEREOF, We have hereunto set my hand at

_____________, this __________________.

___________________________
<NAME>
representing _______________

_________________________
<NAME>

SIGNED IN THE PRESENCE OF

 _____________ ______________________

ACKNOWLEDGMENT

Republic of the Philippines)

Done: City of Baguio ) S.S.

BEFORE ME, a Notary Public, personally appeared the following

persons:

<PARTY and ID>

<PARTY and ID>

Known to me to be the same persons who executed the foregoing

instrument and acknowledge to me that the same is their free and
voluntary act and deed as well as of the corporation or entity
represented.

WITNESS MY HAND AND SEAL this

__________________________________, at _____________________________.
 WAIVER, RELEASE AND QUITCLAIM

I, <NAME>, Filipino, of legal age, single and a resident of Baguio City,

Philippines, after being sworn to in accordance with law, depose and state:

1. That I acknowledge my last day of employment is on December 26, 2017;

2. That I hereby acknowledge that I have received the sum of ONE HUNDRED
SEVENTY THOUSAND PESOS (P170,000.00) as payment of my services;

3. That I hereby declare that I have no further claims whatsoever against

DENTAL CLINIC, its president, members of the Board, officers or any of its
staff, and that I hereby release and forever discharge all of them from any
and all claims, demands, cause of action of whatever nature, arising out of
mu employment with the latter;

4. I further agree that this WAIVER, RELEASE AND QUITCLAIM may be

pleaded in bar to any suit or proceeding (Civil, SSS, PhilHealth, Medicare,
Labor, etc.) to which either I or my heirs and assigns, may have against
Edison Dental Clinic in connection with my employment with the latter and
that the payment which I have received as provided herein should not in
any way be construed as an admission of liability on the part of our
employer and is voluntarily accepted by me and will, if need be, serve as full
and final settlement of any amount due us or any claims or cause of action,
either past, present, future, which I have in connection with Dental Clinic;

5. As such, I finally make manifest that I have no further claim or cause of

action against Dental Clinic or against <Name of Owners> and forever
release them from any and all civil liability.

IN WITNESS, WHEREOF, I have hereunto set my hands this 19 th day of February

2018 in the City of Baguio, Philippines.

<NAME>
Affiant

SUBSCRIBED and SWORN to before me this 19th day of February 2018, in the
City of Baguio, by the Affiant who is personally known to me.