REPUBLIC OF THE PHILIPPINES )

CITY OF CALOOCAN ) S.S

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

AFFIDAVIT OF QUITCLAIM

I, [Consuelo Abella], of legal age, Filipino citizen, and resident of [Your Address], do
hereby declare and state under oath the following:

I am the spouse of Mr. Levi Abella, who is currently on board as a seafarer and unable to
personally appear before the E.J.M Pawnshop to redeem the pawned item of jewelry.

I am requesting to redeem the pawned item of jewelry, identified as [Description of

Jewelry], with Pawn Ticket No. [Ticket Number].

I acknowledge and understand that the E.J.M Pawnshop has a policy requiring the personal
appearance of the pawner or a duly authorized representative for redemption of pawned
items.

In consideration of my request, I hereby execute this Affidavit of Quitclaim to free E.J.M

Pawnshop, its officers, employees, and agents from any and all liability in the future in case
another person appears to redeem the aforementioned pawned item of jewelry on behalf of
my husband, Mr. Levi Abella.

I further declare that I have full authority and consent from my husband, Mr. Levi Abella, to
redeem the pawned item of jewelry in his absence, and I assume all responsibility and
liability for the redemption process.

I understand and agree that this Affidavit of Quitclaim is binding and enforceable, and I will
not hold E.J.M Pawnshop responsible for any claims, disputes, or liabilities arising from the
redemption of the pawned item.

I affirm that the information provided in this affidavit is true and correct to the best of my
knowledge and belief. I understand that any false statements made herein may subject me
to penalties under the law.

IN WITNESS WHEREOF, I have hereunto set my hand this ______________, in

______________________________, Philippines.

MICHAELA JANE ROSITA BERGANTINOS

Affiant

SUBSCRIBED AND SWORN to before me this __________, in _________________________

Philippines, by affiant who is personally known to me and personally signed the foregoing
instrument before me showed her Passport with Passport No. P7907982A and avowed
under penalty of law to the whole truth of the contents of said instrument.

Doc. No. _____;

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