Republic of the Philippines

Technological University of the Philippines

TECHNOLOGY LICENSING OFFICE
INNOVATION and TECHNOLOGY SUPPORT OFFICE
Manila

WAIVER
We, Micaila N. Domingo, Jerick P. Gozon, Aubrey Mae F. Llano, and Liannah Dea R.
Patagnan, of legal age, single, with residence and postal address at 294 Sgt. Mabagos St.,
Tondo, Manila; Blk 3 Lot 33 Phase 1 Southville 8, San Isidro, Rodriguez, Rizal; 15357 Sto.
Niño St., Moonwalk, Parañaque City; 335 Lemon St. Corner Lanzones St., Phase 2, BF
International Village, Las Piñas City after beingduly sworn in accordance with law hereby
depose and say:

1. That we are the creator / author of the work entitled

WELFUR: A Call to Promote the Development of Street Shelters for Stray Cats and Dogs in
Manuyo Dos, Las Piñas City through an Advocacy Ad Campaign, subject of the application
for copyright filed for and on behalf of the TECHNOLOGICALUNIVERSITY OF THE
PHILIPPINES;

2. That we are waiving my right as creator / author of said work in favor of

TECHNOLOGICAL UNIVERSITY OF THE PHILIPPINES and we hereby expressly agree
that the copyright registration certificate therefore be issued in favor of TECHNOLOGICAL
UNIVERSITY OF THE PHILIPPINES.

IN WITNESS THEREOF, I/we have hereunto set my signature on this day

of , , in Manila, Philippines.

CONFORME:

by:

SUBSCRIBED AND SWORN to before me this day of ,

, in , affiant exhibiting to me his Community Tax Certificate No.
issued on at , .

NOTARY PUBLIC

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