Anda di halaman 1dari 2

REPUBLIC OF THE PHILIPPINES

) )

S.S.

AFFIDAVIT OF WAIVER AND QUITCLAIM


I, _________________, Filipino, of legal age, single/married and a resident of __________________________________________________, after having been sworn in accordance with law, hereby depose and state that: 1. I am an employee of Carels Pharmaceutical Inc. with business address at Unit 1402 The Centerpoint Bldg., Garnet Rd., Ortigas Center, Pasig City. 2. I have filed my voluntary resignation with the Company effective on _____________________, attaching hereto as Annex A is a copy of my resignation letter. 3. Upon proper computation by the Companys Finance Department, I am to receive the amount of ___________________________________ (P ____________) as final and full settlement of all such salaries and employment benefits in accordance with the pertinent employment contract provisions and labor laws. 4. I hereby acknowledge receipt of the sum of __________________________ (Php _________), Philippine currency, representing full satisfaction of all my remaining salaries and employment benefits and as a further manifestation of the Carels goodwill towards me and for my benefit. 5. Furthermore, I voluntarily and freely acknowledge that I have no claims or right of action, whether past, present, future or contingent, of whatever nature against Carels Pharmaceutical, Inc., and any affiliated companies, its officers, that may arise relative to my employment with the company, acknowledging further that I had been duly paid all my salaries, emoluments, legal benefits and the like during the existence of my employer-employee relationship with the company and the termination of such relationship in view of my voluntary resignation from the company. 6. I hereby also voluntarily, freely and unconditionally waive any and all such claims, if any, and in executing this waiver and quitclaim, I have fully renounce any claims or right of action of whatever nature, whether past, present, future or contingent against said corporation and its officers, relative to my employeremployee relationship with the company and the termination of such relationship in view of my voluntary retirement from the company. 7. I affirm that I was not forced into resignation and I further affirm and confirm my resignation from the company effective _______________. 8. I fully understand the statements I have made in this document that has been explained to me in a dialect/language I understand. I have affixed my signature hereunder voluntarily and freely with full and complete knowledge of the meaning and intent of this document and of my rights under existing laws. 9. I acknowledge further that any future work or service that I may provide the

Affidavit of waiver and quitclaim, Page 2 of 2

company shall be on a contractual basis, as my regular employment with the company had been extinguished in view of my resignation from the company. AFFIANT FURTHER SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _________ 200__ at _________________________________, Philippines.

__________________ Affiant Conforme: ________________________________ Human Resources Manager

BEFORE ME, a Notary Public, for and in _________________, Metro Manila, this ____ day of ______________________, personally appeared ____________________ with his/her CTC No. ____________________ issued at _____________ on ______________, known to be and to me known to be the same person who executed the foregoing Affidavit of Waiver and Quitclaim and acknowledged to me that the same is his/her free and voluntary act and deed. WITNESS MY HAND AND SEAL on the date and place first herein above stated.

NOTARY PUBLIC Doc. No. Page No. Book No. Series of 20__.