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REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO
)
X--------------------------------------X

DECLARATION AND QUITCLAIM


I_______________________________, of legal age, Filipino Citizen and
resident of ___________________________________, after being duly sworn to in
accordance with law, do hereby depose and state:
1.On _________________________I informed and
notified________________________
(hereinafter called the Releasee) with address
at______________________________________,
That I would resign from my employment
effective_______________________________.
2. During the course of my employment with Releasee, I was treated
fairly and properly. I started working with Releasee on the day I was reported
to the Social Security System(SSS) as shown by the SSS records and I have
voluntary and irrevocably resigned from my employment
on____________________________.
3. I have been paid all my salaries and benefits in accordance with
applicable wage orders and laws and I hereby state further that I have no
claim, cause of action or right of action of whatever nature whether past,
present or contingent against Releasee.
4. For and in consideration of the sum of
______________________________________
(P_____________________________), Philippine Currency, which I hereby
acknowledge to have received in full settlement of any and all claims that I
may have from the Releasee to my full satisfaction, I do hereby waive any
and all my claims and forever release and discharge the Releasee of any and
all claims, liabilities, demands and rights of action whatsoever arising out of
or relating to my employment, separation from my work.
5. This declaration and quitclaim may be pleaded as a bar to any suit
or proceeding which may be taken or have been taken in connection with my
work, separation from my work.
It shall never be construed as an admission of liability or guilt on the part of
the Releasee, but only for the purpose of buying peace and as full payment
or settlement of any and all claims against the Releasee.
6. I am not interested in prosecuting, whether civilly, criminally or
otherwise, the Releasee and I execute this document of my own free will and
volition for the purpose of warranting that I will institute no action and will
refrain from prosecuting him. I request that all complaints and/or cases that I
may have filed against the Releasee be waived, withdrawn, terminated,
and/or dismissed with prejudice.
7. I have read all the contents of this document and the same has been
translated and explained to me in the local dialect and I have fully
understood and voluntarily executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand at Iloilo City,
Philippines this ________ day of _________________________, 2010.

__________________________
Releasor

SIGNED IN THE PRESENCE OF

____________________________

____________________________

REPUBLIC OF THE PHILIPPINES)


CITY OF ILOILO
) S S.
x-----------------------------------------x
Before me this ________day of ______________________, 2010, at Iloilo
City, Philippines, personally appeared ____________________________ with
Identification Card No. Or Community Tax Certificate No.
_______________________ issued at __________________,
_____________________________, known to me and to me that the same is his
own free and voluntarily act and deed.
This instrument relates to a Declaration and Quitclaim consisting of the
two (2) pages including this page whereon this acknowledgement is written
and has been signed on each and every page hereof by the Releasor and his
witnesses.
WITNESS MY HAND AND SEAL at place and on the date first above
written.

NOTARY PUBLIC
Doc. No. ___________;
Page No. ___________;
Book No.___________;
Series of 2010.

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