Republic of the Philippines)

Province of Ilocos Norte)

Laoag City)

AFFIDAVIT OF QUITCLAIM

I, ___________________, Filipino Citizen, of legal age, and resident of

_____________________Laoag City, Ilocos Norte after being duly sworn in
accordance with law, depose and state that:

1. I am an employee of _________________ owned by Mr. and Mrs.

________________;
2. On _____________, I rendered my voluntary resignation;
3. After my resignation, Mr. and Mrs. gave me the amount of
_____________________ representing all the wages and benefits I am
entitled to receive;
4. I already received the amount of _______________________;
5. Wherefore, for and in consideration of the foregoing premises , I hereby
freely and voluntarily RENOUNCE, WAIVE, QUITCLAIM AND
FOREVER RELEASE any and all claims and/or causes of action, which I
may have against _________________ owned by Mr. and Mrs.
________________, their heirs, assigns and successors in interest in a
manner that is absolute and irrevocable regarding my employment;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 21st day

of November 2018 at Laoag City, Ilocos Norte.

____________________
ID No. _______________
Witnesses:

_________________________ _______________________

SUBCRIBED AND SWORN to before me, on the date and place above
mentioned, affiant exhibiting to me his/her identification card as his/her proof
identity.