TIN #: 928123463

ADDRESS: Village 2, 8th street,

Libertad, BUTUAN CITY
TEL # 815-3021
MOBILE #: +63-923-083-0177
+63-917-115-1689
EMAIL ADD:
wilcaretransformer@gmail.com
WILSON S. FLORES JR - PROPRIETOR

Date: October, 20, 2023

AFFIDAVIT OF WAIVER

I, Stephen Rosie Francis, Authorized representative of WILCARE TRANSFORMER AND ELECTRICAL SERVICES, Filipino
citizen, of legal age, resident of P1 ANNEX MARANDING, LANAO DEL NORTE after sworn to in accordance with the law,
hereby declare and state;

1.) That I am a member consumer/applicant/prospective customer of ZAMSURECO-ll;

Particulars WTES

• Quantity 1

• Brand new Recon

• Rewound/Retesting

• Brand name Philec

• Serial number 0911-07922Y221

• KVA Rating 25

• Others 7620/13200y 120/240

3. That I am applying and requesting ZAMSURECO-ll to conduct testing on my Distribution Transformer on the following:

A. Insulation resistance test;

B. Open-Circuit and Short-Circuit Test. Test trials must be minimum of three tests;

C. Oil Dielectric Test; and

D. Distribution Transformer Turns Ratio Test.

4. That in the course of testing, I am allowing ZAMSURECO-ll personnel to open my Distribution Transformer to further check the oil,
among others contained in it, if needed;

5. That I do hereby waive, and convey all my rights, interest over the said Distribution Transformer, that in the course of testing,
whatever findings irregular or may cause damage of the unit, ZAMSURECO-ll assume NO obligations/responsibilities in connection
with the said unit.

IN WITNESS WHEREOF, I have hereunto set my hands this ___ day of October 2023 at ZAMSURECO-ll Pangi, Ipil, Zamboanga
Sibugay, Philippines
 Stephen Rosie Francis

Member-consumer/Applicant ZAMSURECO-ll - Representative