Republic of the Philippines

Department of Labor and Employment

NATIONAL LABOR RELATIONS COMMISSION
National Capital Region
Quezon City

SHAILA ARZADON CABAGTONG,

Complainant,

-versus- NLRC NCR CASE NO. 10-15204-12

CAFÉ XOCOLAT INC.,

RINA AVECILLA,
MICHELLE ORTIZ,
VALERIE LOPEZ,
Respondents.
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QUITCLAIM AND RELEASE

COMES NOW the undersigned parties in the above-entitled case, and unto the
Honorable Office, most respectfully manifests:

That for and in consideration of the sum of SEVENTY FIVE THOUSAND PESOS
(P75,000.00) paid to the complainant Shaila A. Cabagtong, by the respondent Café
Xocolat, Inc., represented herein by Catherine Avecilla and Michelle Ann Ortiz,
managers of said respondent company, representing as FULL AND COMPLETE
SETTLEMENT OF THE ALL CLAIMS acknowledged by the complainant as full
satisfaction, complainant herein hereby release and discharge the said respondents
CAFÉ XOCOLAT INC., CATHERINE AVECILLA, MICHELLE ANN ORTIZ AND VALERIE
LOPEZ, and its officer(s) from any and all claims by way of unpaid wages, overtime pay,
differential pay, separation pay or otherwise as may be due me in connection with my
past employment with said establishment and its officers.

In view hereof, we hereunto set our hands this 17th day of December, 2012, in
Quezon City, Philippines.

SHAILA ARZADON CABAGTONG CAFÉ XOCOLAT INC. by:

CATHERINE AVECILLA

MICHELLE ANN ORTIZ

\WITNESSES: _________________________ _________________________

SUBSCRIBED AND SWORN to before me this ___ day of ____________

Quezon City, affiants are known personally to this Notary Public

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