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WAIVER AND ASSIGNMENT OF RIGHTS

KNOW ALL MEN BY THESE PRESENTS:

We, ______________________, surviving spouse of the late _____________________,

residing at _________________________________, and the children heirs of
________________________ [deceased] namely: (a) ______________________, of legal age,
residing at _____________________________; (b) ___________________________, of legal
age, residing at _____________________________.; (c) ___________________________, of
legal age, residing at 10323_____________________________; and (d)
___________________________, of legal age, and residing at
_____________________________, do hereby WAIVE and ASSIGN our rights as
heirs/beneficiaries to the cemetery plot located in Himlayang Pilipino Memorial Park:
Himlayan Road, Bgy. Pasong Tamo,Tandang Sora, Quezon City, Philippines 1106, known as
____________________________________, and covered by Application #________________
and Certificate of Ownership Contract number _______________________, owned by and
registered to ______________________ [deceased], issued by the Himlayang Pilipino,
Incorporated, with principal place of business at the Triumph Building, 1610 Quezon Avenue,
Quezon City, Philippines 1103, in favor of ___________________________________, also of
legal age, Filipino, her heirs, assigns and successors in-interests, and residing at
__________________________________.

IN FURTHERANCE hereof, it is requested of the Himlayang Pilipino Memorial Park to

recognize and register in their books/records this transfer of ownership and title over said
memorial plot in favor of _____________________________.

IN WITNESS WHEREOF, we have hereunto affixed our signatures on this_______day of

_________________2019 at ____________________________.

____________________________________
Surviving Spouse

HEIRS/BENEFICIARIES OF _____________________

_________________________ ____________________________

_________________________ ____________________________
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ACKNOWLEDGMENT

State of Nevada
County of ______________

This instrument was acknowledged before me on the ____day of_________,________By the

above-named parties.

Notary Signature