REPUBLIC OF THE PHILIPPINES)

================= ) S.S.

AFFIDAVIT OF WAIVER

I, , of legal age, Filipino, single and with residence and postal

address at, after having been duly sworn in accordance with law, hereby
depose and state that:

1. I am an employee of -------------------------;

2. From 20 to 24 August 2018, I will be on leave of absence;

3. During the said dates, I will be travelling in =============;

4. --------------- and its Board of Directors, officers, employees or

representatives will not be held liable for any medical expenses
or personal injury I may sustain while I’m on leave;

5. I am executing this Affidavit of Waiver to attest to the truth of the

foregoing statements and for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

18 June 2018 at ================.

================
Affiant

SUBSCRIBED AND SWORN TO before me this 18 June 2018 at

Alabang, Muntinlupa, affiant exhibited to me her
======================

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2018.