Republic of the Philippines)

Province of_______________) S.S.

City/Municipality of ___________)
x----------------- x

WAIVER, RELEASE AND QUITCLAIM

I, __________________ Filipino, of legal age, (single / married / widow), and a

resident of Philippines, after being sworn to in accordance with law, depose and
state:

1. That by these presents, I hereby state that I have withdrawn my application for
the J1 trainee Program to VISA TO AMERICA and refunded it.

2. That I hereby acknowledge to have received from VISA TO AMERICA, the sum
of Two hundred five thousand, one hundred ninety-two pesos (P205,192. 00_)
which is in full and final satisfaction of my refund and other benefits that may be
due me for the service.

3. That I hereby declare that I have no further claims whatsoever against the
company, its Director Ms. Rose Oller, President, members of the Board, officers or
any of its staff and that I hereby release and forever discharge all of them from
any and all claims, demands, cause of action of whatever nature arising out of my
withdrawal with the latter;

4.I further agree that this WAIVER, RELEASE AND QUITCLAIM may be pleaded in
bar to any suit or proceeding to any criminal cases which either I, or my heirs and
assigns, may have against Visa To America in connection with my application
contract with the latter and that the payment which I have received as provided
herein should not in any way be construed as an admission of liability on the part
of my employer and is voluntarily accepted by me and will, if need be, serve as
full and final settlement of any amount(s) due me or any claims or cause of action,
either past, present, future.
5. As such, I finally make manifest that I have no further claim(s) or cause of
action against VISA TO AMERICA nor against any person(s) connected with the
administration and operation of the latter and forever release the latter from any
and all liability.

IN WITNESS WHEREOF, I have hereunto set my hand this____________ at

___________________Philippines.

Affiant: __________________________

SUBSCRIBED AND SWORN to before this __day of January 2024

Affiant exhibiting to me his Passport No. ______________:
Valid until _________________:
Doc. No. __________________:
Page No. __________________:
Book No. __________________:
Page No. __________________: