Affidavit of Quitclaim Release (Blank)
Affidavit of Quitclaim Release (Blank)
Affidavit of Quitclaim Release (Blank)
) S.S.
AFFIDAVIT OF QUITCLAIM/RELEASE
3. Furthermore, I manifest and voluntarily declare that I have no cause of action or claim whatsoever
against _________________ its officers, agents, or assignees. As a consequence thereof, I shall
desist from filing any complaint, civil, criminal or administrative, against ____________________ its
officers, agents, or assignees in, including but not limited to, all government/administrative agencies,
departments, offices, quasi-judicial agencies, the courts and tribunals of the Republic of the
Philippines.
4. I further manifest that during the entire period of my employment with ___________________ I have
never met any disabling accident, arising out of or in the course of my duties thereat nor have I
become sick or disabled because of such employment;
5. I declare finally that I have read the contents hereof fully and I completely understand the same and/or
that the contents hereof have been fully read and explained in a language or dialect known to me
before signing the same and this Affidavit of Quitclaim/Release is made voluntarily and willingly with
full knowledge of my rights and privileges under the law;
6. I have executed the foregoing affidavit to attest to the truth of the facts hereinstated.
__________________
AFFIANT
WITNESSED BY:
_________________________ _________________________
SUBSCRIBED AND SWORN to before me this ______ day of _____________ 200__, affiant exhibiting to
me her/his C.T.C. No. ______________ issued on ___________________ at ____________________.