Waiver, Release, and Quitclaim

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WAIVER, RELEASE, AND QUITCLAIM

REPUBLIC OF THE PHILIPPINES )


____________________________ ) SS.

I, ________________________, Filipino, of legal age, single/married


to ____________________/widow/widower, and a resident of
__________________, after having been duly sworn in accordance
with law, hereby depose and say:

1. That I am an employee of ______________________,


having connected therewith as _____________________,
since _______________;

2. That I have a letter of resignation with the company effective


_______________________________;

3. That I hereby acknowledge to have received from my


employer the sum of _______________________________
(Php ___________) which is in full and final satisfaction of my
salary and other benefits that may be due me for the service
which I have rendered for the latter employer;

3. That I hereby declare that I have no further claims


whatsoever against my employer, its President, CEO, Chairman
and Members of the Board, officers or any of its 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 the latter;

4. I further agree that this WAIVER, RELEASE AND


QUITCLAIM may be pleaded in bar to any suit or proceeding
(Civil, Labour, SSS, PhilHealth, Medicare, etc.) to which either
I, or my heirs and assigns, may have against my employer in
connection with my employment with the latter 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
my employer and is voluntarily accepted by me and will, if need
be, 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 my
employer;

5. As such, I finally make manifest that I have no further


claim(s) or cause of action against my employer nor against any
person(s) connected with the administration and operation of
the latter and forever release the latter from any and all liability.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


___day of __________, 20_____ at ____________, Philippines.

_________________________________
(Signature of Affiant over Printed Name)

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for


_________(City/Province)____________ this ____th day of ____________
20___. Affiant personally came and appeared with _____________(Competent
Evidence of Identity)______ issued by the _________(Government
Agency)______ on ___(date)__ at ________(place)_________, bearing his
photograph and signature, known to me as the same person who personally
signed the foregoing instrument before me and avowed under penalty of law to
the whole truth of the contents of said instrument.

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