QSF/AS013

RELEASE, WAIVER AND QUITCLAIM

(PASSENGER)
Know all men by these presents:

I LAWRENCE C. ADUCA
___________________________, of legal age and with residence address at
Kalanawi 2, Pres. Quirino, Sultan Kudarat
_____________________________________________________ for good and valuable consideration, receipt of which in full is hereby
acknowledged, hereby releases and discharges Cebu Air, Inc. (“CEBU”), its subsidiaries, divisions, directors, officers, stockholders,
agents, employees, assigns and successors-in-interest and all other persons acting for and its behalf (the “Other Interested Parties”)
from any action of whatever nature, arising from or in connection with (Delayed Baggage Settlement PHP 14,000.00)
_______________________________________.

The execution of this Release, Waiver and Quitclaim (the “Instrument”) is deemed to be, for all intents and purposes, the full
and final settlement of any and all claims which I may have against CEBU, the Other Interested Parties (the “Claims”), all of which
Claims are hereby unequivocally and forevermore disclaimed and waived. I understand that this Instrument may be pleaded as an
absolute and final bar to any and all suits, claims or legal action that may be brought against CEBU by me, my heirs, successors and
assigns, or any other person claiming by, through or against me.

I hereby represent and warrant to CEBU and the Other Interested Parties that:

(a) I am legally capacitated to execute this Instrument and that capacity may be relied upon by CEBU and the Other
Interested Parties to the fullest extent allowed by applicable law;

(b) I fully understand the terms and conditions of this Instrument and has full knowledge of the legal consequences thereof;

(c) I execute this Instrument willingly, voluntarily and in good faith, without the influence of fraud, coercion, threat or
intimidation; and

(d) I shall maintain the confidentiality of this Instrument and I undertake to indemnify and hold free and harmless CEBU and
the Other Interested Parties for any damage it may hereafter sustain should I breach this covenant.

Further, this Instrument and all incidents thereof shall be construed by and in accordance with the laws of the Philippines,
without reference to its conflict of law rules and I hereby agree that any dispute arising from this Instrument including the incident
contemplated thereby, shall be brought before the courts of the Pasay City, Philippines to the exclusion of all other courts. I hereby
waive any right or defense of inconvenience of forum or venue.

IN WITNESS WHEREOF, I have hereunto signed my name this __ day of ______________________.

_______________________________________
LAWRENCE C. ADUCA
Passenger/Shipper, Flight ________________

Signed in the Presence of:

___________________________ __________________________

ACKNOWLEDGEMENT

Republic of the Philippines )

) S. S.

BEFORE ME, a Notary Public for and in _________________, this _____ day of _______________, personally appeared
_________________________ with Passport/License/Other Public ID No. _____________ Issued on/Expiry Date: _______________
and acknowledged to me that he/she is the same persons who executed and voluntarily signed the foregoing Release, Waiver and
Quitclaim as her/his free and voluntary act and deed.

WITNESS MY HAND SEAL this ____ day of _________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of _____.

Date Issued: 18 May 2012 Rev.No./Rev.Date : _______________