Republic of the Philippines )

Caloocan City, Metro Manila ) s.s.

x---------------------------------------------x

WAIVER OF RIGHTS
We, B I E N FLORENCIO DEL ROSARIO, of legal age,
Filipino, widow, a resident of 21 Selecta Drive Balintawak,
Quezon City;
RHUBIEN RAY C. DEL ROSARIO, of legal age, Filipino,
single and a resident of 21 Selecta Drive Balintawak, Quezon
City and;
RHAYMOND RAY C. DEL ROSARIO, of legal age,
Filipino, single and a resident of 21 Selecta Drive,
Balintawak, Quezon City, after having been duly sworn to
in accordance with law hereby depose and state:

1. That we are the legal heirs of the late MA. NANCY

CARNAJE DEL ROSARIO, who died on 24 January 2022 at
Quezon City General Hospital;
2. That during her lifetime, she was an active member
and a lawful holder of St. Peter Life Plan with Contract/Policy
No. 706268;
3. That we, RHUBIEN RAY C. DEL ROSARIO and
RHAYMOND RAY C. DEL ROSARIO do hereby waive,
relinquish, quitclaim and renounce any and all of my rights and
interests, whatsoever over the aforesaid Life Insurance Plan in
favor of our father, BIEN FLORENCIO DEL ROSARIO.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this 27 th

day of February 2023 at Caloocan City, Metro Manila, Philippines.

RHUBIEN RAY C. DEL ROSARIO RHAYMOND RAY C. DEL ROSARIO

Affiant Affiant

BIEN FLORENCIO DEL ROSARIO

Affiant
SUBCRIBED AND SWORN TO before me this 27th day of February 2023
in Caloocan City, Metro Manila, Philippines, affiant exhibiting to me their valid proof of
identification.
(NOTARY PUBLIC)

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.