WAIVER OF RIGHTS For Electric Bill

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WAIVER OF RIGHTS

KNOW ALL MEN BY THIS PRESENTS:

I, Juan, JR., of legal age, Filipino, married, and a resident of Zamora


St., Roxas City, Capiz, under oath declare:

1. That, I am the registered consumer in the electric bill


issued by Capiz Electric Cooperative Inc. with Account
number 17-100000806 and Meter Serial Number 0120000;

2. That, I will be transferring my residence already and it will


be my mother, Juana, who will be residing at the house
where the said meter is installed and will be the one
consuming electric power;

NOW THEREFORE, I do hereby waive and renounce whatever


rights, interest or participation I may have over the aforesaid membership
receipt under Capiz Electric Cooperative Inc. and that the electric bill under
my name be transferred in the name of Juana N. APUYO.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


______________________, Roxas City, Capiz, Philippines.

Juan JR.
Affiant

Acceptance of Waiver:

Juana

SIGNED IN THE PRESENCE OF:

_______________________ ____________________

1
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)


CITY OF ROXAS . . . . . . . . . . . . . .) S.S.
x-------------------------------------------x

BEFORE ME, this ____________________ in the City of Roxas,


Province of Capiz, Philippines, personally appeared JUAN, JR. with
UNIFIED MULTI-PURPOSE I.D. with CRN-006-0000-000-8 and who is
known to me to be the same person who executed the foregoing instrument
and that he acknowledged to me that the same is his free act and deed.

WITNESS MY HAND AND NOTARIAL SEAL, on the date and at the


place first above written.

Doc. No. ______;


Page No. ______;
Book No. ______;
Series of 2020.

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