WAIVER

KNOW ALL MEN BY THESE PRESENTS:

That I, MARISSA OCO GADA, of legal age, Filipino and with postal address at 116
Zone 3 Topas Sogod Nabua, Camarines Sur under oath do hereby depose and state:

1. That I am the mother of JESSA OCO ZARAGOSA, single, 116 Zone 3 Topas Sogod
Nabua, Camarines Sur;

2. That on February 18, 2021, at around 6 o’clock in the afternoon, I received a call that
my daughter, JESSA, was declared dead on arrival;

3. That in order to determine the specific cause of death of my daughter, authorities

require the conduct of an autopsy on the remains of my daughter;

4. That I fully understand that in not performing such autopsy, authorities may not be
able to establish a definite cause of death of my daughter;

5. That I hereby waive our right to the conduct of an autopsy on the remains of my
daughter;

6. That as such, I shall not hold the authorities tasked to conduct an autopsy liable for
any loss, injury, pain or suffering, real or imagined, that may arise from non-
performance of the said autopsy.

IN WITNESS WHEREOF, I have hereunto set my hands this 22 nd day of February 2021
at Paete, Laguna, Philippines.

MARISSA OCO GADA

Affiant

SIGNED IN THE PRESENCE OF:

_________________________ ___________________________

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF LAGUNA )S.S.
MUNICIPALITY OF PAETE )
x-------------------x

BEFORE ME, a Notary Public for and in the Province of Laguna, this 22 nd day of
February 2021, personally appeared MARISSA OCO GADA, by the Affiant who is personally
known to me to be the same person who executed and voluntarily signed the foregoing
WAIVER which she acknowledged before me as her free and voluntary act deed.

WITNESS MY HAND AND SEAL this 22nd day of February 2021 in Paete, Province of
Laguna, Philippines.

Doc. No. 500;

Page No. 106;
Book No. 2;
Series of 2021.