Republic of the Philippines )

City of ____________ ) S.S.

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WAIVER, RELEASE AND QUITCLAIM

I, ________________________________, Filipino, of legal age, married/single, and a resident of
_________________________________, Philippines, after being sworn to in accordance with law, depose and state: that

1. I have voluntarily severed my ties with ________________________________;

2. I hereby acknowledge to have received from the abovementioned company the sum of
____________________________________ PESOS (Php ___________.00) which is in full and final satisfaction of my
salary and other benefits that may be due me for the services which I have rendered for all of the company’s projects;

3. I hereby declare that I have no further claims whatsoever against ___________________________________, their
President, members of the Board, officers or any of their 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 them;

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 employers in
connection with the projects I accepted with them 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 ____________________ and is voluntarily accepted by me and
will 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 them;

5. As such, I have no further claim(s) or cause of action against ________________________ nor against any person(s)
connected with the administration and operation of the said companies and forever release the latter from any and all liability;

7. I am executing this instrument freely and voluntarily without any moral or physical threat and coercion.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________ at Cebu City, Philippines.

_____________ _____________________