Waiver of Right to Recover

I, [Name], hereby waive my right to recover or reclaim the collateral item used to cover the
hospitalization bill under a promissory note and authorize the hospital to sell the same to
cover part of the debt.

I understand that the collateral item was pledged to cover the hospitalization bill and that the
sale of the collateral is necessary to partially repay the debt owed. By signing this waiver, I
acknowledge that I will not be able to retrieve the collateral item once it is sold.

I authorize the hospital to proceed with the sale of the collateral item and allocate the
proceeds towards the repayment of the outstanding debt. I release the hospital from any
liability or claims related to the sale of the collateral item and acknowledge that this waiver is
legally binding.