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

__, a position which I held for my 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 ______ of
______________ 2020 at City of Koronadal, Philippines.

________________
Affiant

SUBSCRIBED AND SWORN TO before me this ____________________ in

____________.

Doc. No. ______ ;

Page No. ______;
Book No. ______;
Series of _______