RELEASE WAIVER AND QUITCLAIM

KNOW ALL MEN BY THESE PRESENTS:

That I, CERILIO DELA CRUZ, Filipino, of legal age, married and a resident of
Barangay Bagong Sikat, Cabanatuan City, do by these presents acknowledge and
express my deepest gratitude to RONNIE D. LANGIT of Brgy. Bantog, Bongabon,
Nueva Ecija for answering my medical expenses, surgery and hospital confinement
amounting to SIXTY THOUSAND PESOS (P60,000.00) more or less plus receipt of the
sum of TEN THOUSAND PESOS (P10,000.00) Philippine Currency, in full payment and
final settlement of all my claims of whatever kind and nature which I have or may have
against RONNIE D. LANGIT, arising from my injuries as a result of a vehicular accident
which transpired on November 4, 2013 at Burgos Ave, Cabanatuan City, to which
RONNIE D. LANGIT is not at fault and completely free of any liability as the said
incident is purely an accident and unintentional arising from circumstances that
RONNIE D.LANGIT has no control or influence whatsoever.

In consideration of said payment and generous medical and hospitalization

assistance, I do hereby quitclaim, release, discharge and waive any and all actions
of whatever nature, expected, real or apparent, which I may have against RONNIE
D. LANGIT by reason of or arising from my injuries. I will institute no action,
whether civil, criminal or administrative against RONNIE D. LANGIT. Any and all
actions which I may have commenced either solely in my name or jointly with others
before any office, board, bureau, court, or tribunal against RONNIE D. LANGIT are
hereby deemed and considered voluntary withdrawn by me and I will no longer testify or
continue to prosecute said action(s).

I declare that I have read this document and have fully understood its contents.
I further declare that I voluntarily and willingly executed this Release, Waiver and
Quitclaim with full knowledge of my rights under the law.

IN WITNESS WHEREOF, I have hereunto set my hand at Cabanatuan City, this

nd
22 day of November, 2013.

CERILIO DELA CRUZ

Affiant

SIGNED IN THE PRESENCE OF

_______________________ ______________________

SUBSCRIBED AND SWORN TO before me this 22ND day of November 2013

hereat Cabanatuan City, affiant exhibiting to me his ____________________________.

Doc. No.
Page No.
Book No.
Series of 2013