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    Quitclaim, Waiver and Release: I, Aaaa, of Legal Age, (Status), Filipino, and A Resident of

    Uploaded by

    Angela Nuñez
    The document is a quitclaim, waiver, and release signed by an individual named aaaa. It states that aaaa received 15,000 PHP from bbbb company to cover medical expenses from an injury sustained in an incident on October 5, 1998. Aaaa releases bbbb company from any liability or claims regarding the incident. Aaaa also acknowledges understanding this waiver and that the payment does not imply admission of liability by bbbb company.

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    © All Rights Reserved
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    Quitclaim, Waiver and Release: I, Aaaa, of Legal Age, (Status), Filipino, and A Resident of

    Uploaded by

    Angela Nuñez
    107 views2 pages
    The document is a quitclaim, waiver, and release signed by an individual named aaaa. It states that aaaa received 15,000 PHP from bbbb company to cover medical expenses from an injury sustained in an incident on October 5, 1998. Aaaa releases bbbb company from any liability or claims regarding the incident. Aaaa also acknowledges understanding this waiver and that the payment does not imply admission of liability by bbbb company.

    Original Title

    QUITCLAIM

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    The document is a quitclaim, waiver, and release signed by an individual named aaaa. It states that aaaa received 15,000 PHP from bbbb company to cover medical expenses from an injury sustained in an incident on October 5, 1998. Aaaa releases bbbb company from any liability or claims regarding the incident. Aaaa also acknowledges understanding this waiver and that the payment does not imply admission of liability by bbbb company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    107 views2 pages

    Quitclaim, Waiver and Release: I, Aaaa, of Legal Age, (Status), Filipino, and A Resident of

    Uploaded by

    Angela Nuñez
    The document is a quitclaim, waiver, and release signed by an individual named aaaa. It states that aaaa received 15,000 PHP from bbbb company to cover medical expenses from an injury sustained in an incident on October 5, 1998. Aaaa releases bbbb company from any liability or claims regarding the incident. Aaaa also acknowledges understanding this waiver and that the payment does not imply admission of liability by bbbb company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    QUITCLAIM, WAIVER AND RELEASE

    I, aaaa, of legal age, (status), Filipino, and a resident of


    ____________________________, under oath, depose and state that:

    1. I am the principal claimant in the incident that happened last October 5, 1998 at 123
    Plaza, that resulted to injury to my leg (“subject incident”).

    2. I have received from bbbb company the amount of FIFTEEN THOUSAND PESOS
    (Php 15,000.00) to cover all the medical expenses that I incurred to treat the injury I sustained
    in the subject incident.

    3. For the above-stated consideration, I hereby freely, voluntarily and intelligently


    release and forever discharge bbbb company., and/or its directors, stockholders, or officers, for
    any matter cause, demand or damages I may have against any and or all of them, by reason of
    or incidental to the subject incident.

    4. I also freely understand and manifest that the payment of the foregoing consideration
    shall not be taken by me, my heirs, successors or assigns as a confession and /or admission of
    liability on the part of bbbb company and/or its directors, stockholders, or officers, for any matter
    cause, demand or damages I may have against any and or all of them, by reason of or
    incidental to any case arising from the said accident.

    5. I understand that my execution of this Waiver And Quitclaim can be invoked as bar
    against any claim with respect to the matters set forth herein which I may later have against
    bbbb company., and/or its directors, stockholders, or officers,

    6. I finally declare that I have read and fully understand the content of this Waiver And
    Quitclaim which hereby being given willingly, voluntarily, and with full knowledge and
    understanding of my rights under the law.

    IN WITNESS WHEREOF, I hereunto set my hand this ___________________________


    at ________________________________.

    aaaa
    Affiant

    SIGNED IN THE PRESENCE OF:

    ______________________________ __________________________

    ACKNOWLEDGEMENT
    REPUBLIC OF THE PHILIPPINES)

    ___________________________ ) s.s.

    BEFORE ME, a Notary Public in and for _____________________, personally


    appeared Oscar M. Cruz with his Gov’t Issued ID No. __________________ issued on
    _______________________ at ______________________, known to me and by me known to
    be the same person who executed the foregoing Release, Waiver and Quitclaim, and who
    acknowledged to me that the same is his free and voluntary act and deed.

    IN TESTIMONY WHEREOF, I have hereunto set my hand and affix my Notarial Seal
    this _____ day of __________________,20___ in __________________, Philippines.

    Doc. No.______ : NOTARY PUBLIC


    Page No.______ :
    Book No.______ :
    Series 20_______:

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