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 __Position Held__ of __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 this _____________ at _____________, Philippines.

Affiant
ID #____________

SUBSCRIBED AND SWORN to before me this ____ day of _________, in the City of _______, the affiant
exhibited to me the competent evidence of identity shown above.

Doc. No.: ________;

Page No.: ________;
Book No.: ________;
Series of 20____
Republic of the Philippines)
Province of ____________________) S.S.
City/Municipality of _____________)
x––––––––––––––x

WAIVER, RELEASE AND QUITCLAIM

Ako, si _____________, nasa hustong gulang, Filipino, at nakatira sa _____________________________, pagkatapos
manumpa sa ilalim ng batas, ay kusang-loob na naglalahad na):

1. Na ako ay naging empleyado ni_______________________ bilang isang _____________________

2. Noong ________, 20____, ako ay bumitiw (resign) sa aking trabaho ng kusang-loob na walang pananakot, pananakit,
panlilinlang o pamimilit.
3. Sa panahon ng aking pamamasukan, nakuha at natanggap ko ang lahat ng aking sahod at benepisyo mula sa kompanya.
Dahil dito, pinawawalang-sala ko ang aking mga amo/employer/mga empleyado nito, kamaganak at mga tagapagmana
sa anumang mga kahilingan, reklamo, na may kinalaman sa pera, danyos, pagkukulang na nag-ugat o nagresulta sa
aking pagiging empleyado; 
4. Aking pinatutunayan na sa halagang _______________________________ PESOS (PhP____.00) na aking natanggap,
bilang buong kabayaran at settlement sa lahat ng aking sahod at benepisyo na nakapaloob ang natitirang service
incentive leave, bahagi ng 13th month pay, sahod, at iba pa, ang employer ko ay wala nang pananagutan sa akin;
5. Na aking pinatutunayan at pinaninidigan na ang Release, Waiver and Quitclaim na ito ay maaring gamitin laban sa akin
at sa aking mga kamag-anak sa anumang asunto, upang ipawalang-bisa ang kaso maging ito man ay isinampa na o
isasampa pa lang sa hinaharap. Ang mga nilalaman nito ay sumasakop din sa aking mga kamag-anak at tagapagmana.
Kung sakaling ang employer ay ihabla na may kinalaman sa Release, Waiver and Quitclaim  na ito, ako ay nangangako
na depensahan ang employer at sasagutin ang anumang gastusin sa demandang nabanggit;
6. Sinisigurado ko at ginagarantiya na naiintindihan ko nang lubos ang mga terminolohiya, nilalaman at kondisyon sa
dokumentong ito. Ang mga ibig sabihin at epekto ng dokumentong ito ay ipinaliwanag sa akin sa salitang o wikang
aking naiintindihan at ito ay aking naiintindihan nilagdaan nang kusang-loob, na walang pananakot, pananakit,
panloloko, panlilinlang o panghihikayat mula sa o anumang paraan na makakaapekto sa aking boluntaryo na pagpirma
nito.

Bilang patunay, nilagdaan ko ang kasulatang ito ngayong ika ______ ng __________ 20___ sa Lungsod ng ____________.

                                                                                                                                                                                                          
____________________________

                                                            Affiant
                                                            ID: _________________________

SUBSCRIBED AND SWORN to before me this ____ day of _________, in the City of _______, the affiant exhibited to me the
competent evidence of identity shown above.

Doc. No.: ________;

Page No.: ________;
Book No.: ________;
Series of 20____