WAIVER OF RIGHTS

I ____________________ of legal age, Filipino, Married, a Resident of

_________________________________________ after having been
sworn in accordance with the law depose and say:
1. That we are legal heirs of the Late __________________, who
died on _______________ at
________________________________ :
2. That during his lifetime, he was an active member of and a lawful
holder of St. Peter Life Plan with Contract no._________________:
3. That I ____________________ do hereby waive, relinquish,
quitclaim and renounce any and all of my rights and interests,
whatsoever, over the aforesaid St. Peter Life Plan Insurance in
favor of my Sister ,__________________ Legal age , Filipino and a
resident of
_____________________________________________.

That I executing this waiver of Rights to attest to the truth of the

above statement and this serve all legal purposes.

______________________
Assignee