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Release, Waiver and Quitclaim: Notary Public

A person involved in a vehicular accident signed a release waiving their right to take legal action against the other driver who was not at fault for the accident. They acknowledged being paid in full for any damages from the incident. They agreed to withdraw any current or future civil, criminal, or administrative complaints against the other driver for the accident. The person declared understanding the release and signing it voluntarily.

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Concon Hernandez-Beloso
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158 views

Release, Waiver and Quitclaim: Notary Public

A person involved in a vehicular accident signed a release waiving their right to take legal action against the other driver who was not at fault for the accident. They acknowledged being paid in full for any damages from the incident. They agreed to withdraw any current or future civil, criminal, or administrative complaints against the other driver for the accident. The person declared understanding the release and signing it voluntarily.

Uploaded by

Concon Hernandez-Beloso
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES }

MUNICIPALITY OF MABINI } S.S.

RELEASE, WAIVER AND QUITCLAIM

I, _____________________________, Filipino, of legal age, married, with address at


_____________________________, after being duly sworn to in accordance with law, hereby depose and
state that:

1. That on _____________________________I figured in a vehicular accident when the motor vehicle


that I was driving collided with another vehicle registered under _____________________________,
and driven by _____________________________, a resident of _____________________________;

2. That for the damages caused, _____________________________has paid in full and final settlement
all and any claims arising from the incident, to which she is not at fault and completely free from any
liability, as the said incident is purely an accident, and unintentional arising from circumstances that
_____________________________had no control or influence whatsoever;

3. That in consideration for the said payment, I do hereby quitclaim, release, discharge and waive any
and all actions of whatever nature, expected, real or apparent, which I may have against
_____________________________. I will institute no action, whether civil, criminal or
administrative against _____________________________NAPA. Any and all actions which I may
have commenced either solely in my name, or jointly with others before any office, board, bureau,
court or tribunal against _____________________________, are hereby deemed and considered
voluntary withdrawn by me and I will no longer testify or continue to prosecute;

4. That I declare that I have read this document and have fully understood its contents. I further declare
that I voluntarily and willingly executed this Release, Waiver and Quitclaim with full knowledge of
my rights under the law.

IN WITNESS WHEREOF, I have set my hand this _____________________________in


_____________________________, Philippines.

_______________________________________

Affiant

SUBSCRIBED AND SWORN TO before me, on the date and place above-mentioned by
the affiant who exhibited to me specified competent evidence of identity as written under the
name, and as required under the 2004 Rules on Notarial Practice, as amended by A.M. No. 02-8-
13-SC.

Notary Public

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