(Waiver Release and Quitclaim)

Republic of the Philippines)

Province of ____________________) S.S.
City/Municipality of _____________)
x--------------x

WAIVER, RELEASE AND QUITCLAIM

I, _____________, Filipino, of legal age, (single / married / widow),
and a resident of _____________, Philippines, after being sworn to
in accordance with law, depose and state:
1. That by these presents, I hereby state that I have voluntarily
resigned as __Position Held__ of __Employer__;

2. That I hereby acknowledge to have received from my employer

the sum of __________________________ (P_____________)
which is in full and final satisfaction of my salary and other benefits
that may be due me for the service which I have rendered for the
latter employer;

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

against my employer, 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 my 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 my employer 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 my employer and is
voluntarily accepted by me and will, if need be, serve as full and
final settlement of any amount(s) due me or any claims or cause of
action, either past, present, future, which I may have in
connection with my employment with my employer;
5.As such, I finally make manifest that I have no further claim(s) or
cause of action against my employer nor against any person(s)
connected with the administration and operation of the latter and
forever release the latter from any and all liability.
IN WITNESS WHEREOF, I have hereunto set my hand this
_____________ at _____________, Philippines.

Affiant
(JURAT)