Republic of the Philippines }

City/Municipality of Manila } S.S.

National Capital Region

AFFIDAVIT OF WAIVER AND QUITCLAIM

I, ___________________, of legal age, single/married, and residing

at ________________________, Philippines, after having been duly
sworn to in accordance with law, hereby depose and state:

1. That I am an employee of UNDERGROUND TECHNOLOGIES INC.,

having been connected therewith as _______________ ___, since
____________- __up to_______________________;

2. That I hereby acknowledge receipt of the amount of

13 Month with the amount of ______________________(Php_________) and a
TH

Separation pay amounting of ______________(Php_____) Philippine currency, as

full payment of my SERVICE, to my full and complete satisfaction;

3. That I hereby relieve discharge said UNDERGROUND

TECHNOLOGIES INC. and it’s officers from any and all claims by way of
unpaid wages, separation pay, overtime pay, 13 th month pay or otherwise as
may be due me or incident to my employment with said company;

4. That I hereby state further that I have no claim, right or action of

whatsoever nature, whether past, present or contingent, against said company
and its officers;

5. That the contents of this document, although prepared in English, was

interpreted and explained to me in FILIPINO AND ENGLISH, a language
known and understood by me, and the contents of this affidavit is
therefore fully understood by me;

6. That I am executing this instrument freely and voluntarily without any

moral or physical threat, coercion or promise of reward in any form.

IN WITNESS WHEREOF, I hereby affixed my signature this___ day of

_____________2023 at the City/Municipality of ______________, Philippines.

__________________________
(SIGNATURE OVER PRINTED NAME)
Affiant

SUBSCRIBE AND SWORN TO before me this ___________ day of

___________,2023, at the City/Municipality of _______________, Philippines,
affiant exhibited to me his ____________________________________________.

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2023