WAIVER, WAIVER AND QUITCLAIM

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________, of legal age, Filipino, single, and a resident of

___________, after having been duly sworn to in accordance with law, hereby depose and
state:

1. That I was an employee of ___________________, occupying the position of _____.

2. That upon my separation from the COMPANY, the latter has already paid to me all
amounts that are due me by reason of and incident to my employment, as provided
for by law;

3. That I hereby relieve and discharge said COMPANY and its officers from any and all
claims by way of unpaid wages, separation or retirement pay, overtime pay, 13th
month pay and social benefits or otherwise as may be due me or incident to my
employment with said COMPANY;

4. That I hereby state further that I have no claim, right, or cause of action of
whatsoever nature, whether past, present or contingent, against said COMPANY and
its officers, monetary or otherwise, whether incident to my employment or
termination and that the Company had no fault whatsoever in relation to my
separation from employment;

5. That the contents of this document was fully explained to me in a language I know
and understand, and said contents are well understood by me;

6. That I am executing this instrument freely and voluntarily without any moral or
physical threat, coercion or promise of reward in any form.

IN WITNESS WHEREOF, I hereby affixed my signature this _____ day of

_____________ in Davao City, Philippines.

________________
Affiant
Valid I.D.: ____________________________

SIGNED IN THE PRESENCE OF: _________________ _________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

City of ) s.s.
x ---------------------------------------------- x

BEFORE ME, a Notary Public for and in City, this _____ day of _________________
personally appeared the above named person, who exhibited to me competent evidence of his
identity, known to me to be the same person who executed the foregoing instrument and she
acknowledged to me that the same is his free and voluntary act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and affix my notarial seal in the place
and date of the first above-written.

Doc. No. ________;

Page No. ________;
Book No. ________;
Series of 2019.