Affidavit of Release, Waiver, and Quitclaim for Employment - Word & PDF Template Form

REPUBLIC OF THE PHILIPPINES )
________, ________ ) S.S.

AFFIDAVIT OF RELEASE, WAIVER, AND QUITCLAIM

I, ________, of legal age, Filipino, single, with Tax Identification Number ________, presently residing at ________ (the "Affiant"), after having been duly sworn to in accordance with law, do hereby depose and state that:

§ 1. Employment. I was employed in the position of ________ by ________ (the "Employer"), a company duly organized and existing under the laws of the Republic of the Philippines, with principal business address at ________, commencing on ________;

§ 2. Cessation of Employment. I have voluntarily tendered my resignation from the Employer, which became effective on ________, of my own free will and without any coercion, force, or undue influence on the part of the Employer;

§ 3. Composition of the Final Settlement. The full and final settlement of my monetary entitlements arising from my employment, in accordance with Articles 102, 103, and 116 of the Labor Code of the Philippines and applicable Department of Labor and Employment (DOLE) issuances, including but not limited to my last salary, pro-rated 13th month pay under Presidential Decree No. 851, cash conversion of accrued leave benefits, and other lawful benefits due me, is itemized as follows:

________ — ________ (₱________);

§ 4. Total Settlement Amount. The aggregate net amount of ________ (₱________) (the "Final Settlement") is to be received by me from the Employer as the full, final, and complete settlement of all my remaining salaries and other contractual and statutory benefits;

§ 5. Acknowledgment of Receipt. I hereby acknowledge having received from the Employer the sum of ________ (₱________), by way of ________, in full and complete satisfaction and settlement of all my remaining salaries, benefits, claims, and emoluments of whatever nature arising out of or in connection with my employment with the Employer;

§ 6. Full Payment During Employment. I further acknowledge that I have been duly and fully paid all my salaries, wages, and contractual and statutory benefits during the entire period of my employment with the Employer, up to and including the date of the effectivity of my voluntary resignation;

§ 7. No Further Claims. I have no further claims of any kind or nature whatsoever against the Employer and/or its directors, officers, stockholders, employees, agents, representatives, successors-in-interest, and assigns;

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§ 10. Confidentiality and Data Privacy. I undertake to keep confidential all proprietary and confidential information of the Employer that came to my knowledge during my employment, and I acknowledge that my personal data has been processed in accordance with the Data Privacy Act of 2012 (Republic Act No. 10173);

§ 11. Voluntariness. I have read and fully understood this Affidavit of Release, Waiver, and Quitclaim, the contents of which were explained to me in a language known to me, and the same is given and executed by me freely, willingly, voluntarily, and with full knowledge of my rights under the law, without any threat, violence, duress, intimidation, or undue influence exerted upon my person; and that the consideration herein is reasonable, credible, and not unconscionable; and

§ 12. Purpose. I am executing this Affidavit to attest to the truth of the foregoing and for all legal purposes it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this ________ day of ________ at ________, Philippines.

________
Affiant
Competent Evidence of Identity: ________

Signed in the presence of:

________
Witness

________
Witness

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )
________ ) S.S.

SUBSCRIBED AND SWORN TO BEFORE ME this ________ day of ________, 20________ at the City/Municipality of ________, Province of ________, affiant ________ personally appeared before me and exhibited to me the following competent proof of identity: ________,

known to me and to me known to be the same person who executed the foregoing Affidavit of Release, Waiver, and Quitclaim consisting of ________ page(s), including this page where the acknowledgment is written, and he/she 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 above written.

________
NOTARY PUBLIC

Doc. No.: ________;
Page No.: ________;
Book No.: ________;
Series of ________.