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Release and Quitclaim

Pagbibitiw Ng Paghahabol

That I, _________________________________________ the undersigned employee of


SSBN Construction Inc. (“Company”).
Na ako, _____________________________________ ang nakalagdang Mang-gagagwa ng
SSBN Costrustion Inc. (“Kumpanya”).

After being sworn in accordance with law, hereby depose and say;
Pagkatapos sumumpa sang-ayon sa batas, ay nagsasabi;

For in consideration of the sum of Six Thousand Eight Hundred Forty-Two and 14/100 pesos
(Php 6,842.14)
Na alang-alang sa halagang Anim na Libo Walong Daan Apatnaput Dalawa at 14/100 piso
(Php 6,842.14).

Philippine currency, given by my employer, in settlement of all my claims and as financial


assistance and receipt of which is hereby acknowledge to my full and complete satisfaction,
I hereby release and discharge the Company, and/or its President, Board of Directors,
officers, managers, representatives, or agents from any and all claims by way of unpaid
wages, separation pay, retirement pay, holiday pay, service incentive leave, thirteen month
pay, retirement pay, SSS and Medical contributions, overtime pay, differential pay, and
other benefits or otherwise as may be due me incident to my past employment with said
establishment.

Salaping Pilipinas, na sa akin ibinigay at ibiniyad ng aking pinaglilingkura bilang


pagsasaayos ng lahat ng aking paghahabol at bilang tulong pananalapi at ipinagbigay-alam
na aking natanggap ng buong kasiyahan, ay aking kinakalagan, at pinakakawalan ang
Kumpanya, at/o sa kanyang Presidente, mga director, opisyales, pinuno, kinatawan at
tagasunod sa anuman at lahat ng reklamo, daing o karapatang paghahabol mayroon ako
ayon sa batas ukol sa kulang o di-nabayarang sahod, allowance, holiday pay, service
incentive leave, 13th month pay, retirement pay, kontribusyon sa SSS at Medicare, at iba
pang biyaya o benepisyo nararapat sa akin kaugnay ng aking nakaraang pag-trabaho o pag-
empleyo sa nasabing kumpanya, at isinuko at tinalikuran sa pamamagatin nito ang lahat at
anumang reklamo, daing, or karapatang paghahabol mayroon ako laban sa Kumpanya.
I hereby state further that I have no more claim, right, or overtime pay, action of
whatsoever nature, whether past, present or contingent against the Company and/or its
directors, officers, managers, representatives, or agents.

Akin ding hinahayag na wala akong paghahabol o karapatan ng pagsakdal o paghabla, ni


ano mang uri, maging sa nakalipas, ngayon o sa hinaharap, laban sa Kumpanya, at/o sa
kanyang mga director, opisyales, pinuno, kinatawan at tagasunod.

IN WITNESS WHEROF, I have herunto set my hand this


BILANG PATUNAY, sa lahat ng nakasaad dito, ito ay aking nilagdaan ngayong
___________________ sa ___________________.

SIGNED IN THE PRESENCE OF


MGA SAKSI

________________________________ ________________________________

Before me, a Notary Public for and in ________________ this _____________________,


personally came and approved the above-named employee with valid
__________________ ID no ______________ known to me to be the same person who
executed the foregoing Releases and Quitclaim and he acknowledged to me that the same is
his free and voluntary act and deed .

Doc. No: ____________


Page No: ____________
Book No.: ___________
Series of : ___________

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