(Waiver Release and Quitclaim)

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 voluntarily resigned as
__Position Held__ of __Employer__;

2. That I hereby acknowledge to have received from my employer the sum

of __________________________ (P_____________) which is in full and
final satisfaction of my salary and other benefits that may be due me for the
service which I have rendered for the latter employer;

3. That I hereby declare that I have no further claims whatsoever against

my employer, its 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
employment with the latter;

4. I further agree that this WAIVER, RELEASE AND QUITCLAIM may be

pleaded in bar to any suit or proceeding (Civil, SSS, PhilHealth, Medicare,
Labor, etc.) to which either I, or my heirs and assigns, may have against my
employer in connection with my employment 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, which I may have in connection with my
employment with my employer;
5.As such, I finally make manifest that I have no further claim(s) or cause of
action against my employer 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

(JURAT)