MANILA ELECTRIC COMPANY

UNDERTAKING AND QUITCLAIM

I, ___________________________________, represent and attest to the following facts:

I/ our Company, ___________________________________________________,

actually used and paid for the bills of the electric service at
__________________
_________________________________________________________________
with Service Identification Number (SIN) _________________during the period
from _________________up to _________________.

I/ our Company hereby represent/s as the rightful claimant and owner of the
amount to be refunded by MERALCO under the said SIN.

It is understood that my/ our Company’s receipt of the refund amount shall be
deemed a full and final settlement of the refund due and payable under the
subject electric service and shall release MERALCO, its Board of Directors,
officers, employees and representatives from any further obligation or liability
with respect thereto.

In case of fraud, deceit or erroneous payment to me / our Company of the said

refund, I / our Company hereby agree/s that MERALCO shall have the right to
stop the payment of any remaining amount, and I / our Company hereby
undertake/s to reimburse MERALCO or pay the rightful claimant / owner the
amount received by me / our Company plus damages and expenses.

________________________________
Signature over Printed Name

Refund Claimant

_______________________
Date Signed