Republic of the Philippines 

)
City of Cadiz               ) S.S.
x--------------------------x

RELEASE AND WAIVER

            I, JOSEPH CONIENDO Y NATAD, of legal age, married, Filipino

citizen, and presently residing at Roxas Street, Sagay Ciy, after having been
duly sworn to in accordance with law, do hereby depose and say:

1. That as a result of a motor vehicle accident which occurred on 25 January

2023 in Cadiz City, I was one of the drivers who was the victim of the said
Accident.

2. We agree for the release for the 10-wheeler involved in the said vehicular
accident with Plate Number MBA 610. Likewise, my LTO Driver’s License
would be also subject for release.

3. That in order to settle the case amicably and since the owner of the had
offered to pay the sum of ______________ for all damage to property and
the losses that I sustained, which I hereby acknowledge, I am not
interested in filing both civil and criminal cases;

4.  That by virtue thereof, I hereby waive any and all claims, criminal or civil,
against said persons, and further release and discharge them from any and
all liability.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day

of March 2023 at Cadiz City, Philippines.
                            
                                                
JOSEPH CONIENDO Y NATAD
Affiant
                                                           
                       

            SUBSCRIBED AND SWORN to before me this ____ day of March 2023 in

Cadiz City, Philippines, affiant exhibiting to me his competent evidence of identity by
way ____________ issued at Cadiz City on _______.

Doc No. :  _____                                                             

Page No.: ______                                           
Book No.: ______                                              
Series of 2023.                                                              Notary Public