REPUBLIC OF THE PHILIPPINES )

QUEZON CITY ) S.S.

AFFIDAVIT OF WAIVER

I, _______(name)______, of legal age, Filipino, and with residence and postal address at
_________________(address)______________, after having duly sworn to in accordance with
law, depose and state that:

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of October, 2022
in Quezon City.

_______________(NAME)_______________
Affiant

SUBSCRIBED AND SWORN to before me, this ____ day of November, 2022 in
Quezon City, with affiant exhibiting his/her ____(ID no.)_____.

NOTARY PUBLIC

Doc. No.: ____;

Page No.: ____;
Book No.: ____;
Series of 2022.