Republic of the Philippines)

______________________ )

RELEASE, WAIVER AND QUITCLAIM

I, (name of DAMA Claimant or representative), of legal age, Filipino,

presently residing at ___________________________, after having been duly
sworn to in accordance with law, do hereby depose and state that:

1. I am one of the claimants in the case NPC Drivers and Mechanics

Association, et. al. vs. National Power Corporation, et. al., docketed as
G.R. No. 156208 (the “DAMA Case”).

(No. 2 only for Representative as per SPA)

2. I am the duly authorized and designated representative of (name of
DAMA Claimant) who is one of the claimants in the case NPC Drivers and
Mechanics Association, et. al. vs. National Power Corporation (NPC), et.
al., docketed as G.R. No. 156208 (the “DAMA Case”), as shown in the
attached (state title of attached document showing proof of
authorization [e.g., duly notarized Special Power of Attorney]).

3. I am to receive from NPC and Power Sector Assets and Liabilities

Management Corporation (PSALM) the payment and settlement based on
the COA Validated Amount LESS: (1) statutory deductions for the
judgment obligation/money claim in the DAMA Case as decided by the
Supreme Court (SC) en banc in SC Resolution dated 21 November 2017
and the Commission on Audit (COA) in COA Decision No. 2019-416 dated
23 September 2019; and (2) the 10% Attorney’s Lien as validated by the
COA.

4. I hereby certify that the amount to be received as explained in item 3

above is in satisfactory and full payment of all the claims or obligations
of whatsoever kind or character that (I or [name of DAMA Claimant])
may have, or may ever have had, against NPC and PSALM under the law
or in relation to the DAMA Case.

5. Upon receipt of the amount in item 3, (I or [name of DAMA Claimant])

have no further claims whatsoever against NPC and PSALM and thereby
releases, remises and forever discharges NPC and PSALM, their agents,
assigns and successors-in-interest from any action, sum of money, or
other obligations arising from the DAMA case.

6. (I or [name of DAMA Claimant]) further agree that this Release, Waiver

and Quitclaim may be pleaded in bar to any suit or proceeding to which
either (I or [name of DAMA Claimant]), or (my/his/her) heirs and
assigns, may have against NPC and PSALM in connection with the DAMA
Case.

7. (I or [name of DAMA Claimant]) declare that the release, waiver and

quitclaim hereby given is made willingly and voluntarily and with full
knowledge of (my/his/her) rights under the laws.

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 IN WITNESS WHEREOF, we have executed this instrument this _____ day
of __________ 2020 at Quezon City.

name of DAMA Claimant or representative

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this _____ day of _____________

2020 in _______________, affiant, (name), personally appeared before me and
exhibited to me (his/her) (valid government identification card) with no.
___________ issued on __________ at ____________.

Witness my hand and seal this _____ day of _______________ 2020.

NOTARY PUBLIC

Doc. No. _____;

Page No. ____
Book No. _____;
Series of 2020.

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