REPUBLIC OF THE PHILIPPINES )

CITY OF DUMAGUETE . . . . . . . . .) S.S.

WAIVER OF RIGHTS AND ASSUMPTION

I, ________________________, of legal age, married, Filipino and with
residence address at Balugo Habitat II, Dumaguete City, Negros Oriental
Philippines, under oath, hereby state:

1. That I, _______________________, am the registered owner of NORECO

II Electrical Meter No. ___________, under account number
_______________, for my residential building situated at Balugo Habitat II,
Negros Oriental;

2. That by these presents, I, _____________________, hereby,

WAIVE, CONVEY and TRANSFER all my rights, interest and participation over
the said NORECO II Electrical Meter No. __________, under account number
______________, in favor of _________________;

3. That I, ___________________, assumes responsibility of punctual

payment of my NORECO II monthly electrical bills for the aforementioned meter;

4. That we are executing this affidavit to attest the veracity of our

foregoing statements and to support the petition of _________________ with the
NORECO II to transfer to her name NORECO II Electrical Meter No.
___________, under account number ________________ and to become the
absolute owner thereof;

5. That I am executing this Affidavit to attest to the truth of the foregoing

statement of facts.

IN WITNESS WHEREOF, I hereunto set my hand this _______________ in

________________, Philippines.

_______________________ ______________________
Affiant Affiant

SUBSCRIBED AND SWORN to before me a Notary Public of the City of

_________________, this _________________ by affiant exhibiting to me her
Drivers License No. ________________ and she acknowledged to me that she
understood the foregoing affidavit and that she freely signed the same.

Doc. No. __;

Page No. __;
Book No. __;
Series of 20__.