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    Exit Clearance Waiver

    Uploaded by

    Edward Kenneth Kung
    The document is an exit clearance waiver from an employee resigning from a company. It details that the employee received final payment, refused medical exams, and waives any future claims against the company regarding their employment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Exit Clearance Waiver

    Uploaded by

    Edward Kenneth Kung
    39 views2 pages
    The document is an exit clearance waiver from an employee resigning from a company. It details that the employee received final payment, refused medical exams, and waives any future claims against the company regarding their employment.

    Original Description:

    Waiver of refusal to submit to exit medical clearance

    Original Title

    EXIT CLEARANCE WAIVER

    Copyright

    © © All Rights Reserved

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    DOCX, PDF, TXT or read online from Scribd

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    The document is an exit clearance waiver from an employee resigning from a company. It details that the employee received final payment, refused medical exams, and waives any future claims against the company regarding their employment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    39 views2 pages

    Exit Clearance Waiver

    Uploaded by

    Edward Kenneth Kung
    The document is an exit clearance waiver from an employee resigning from a company. It details that the employee received final payment, refused medical exams, and waives any future claims against the company regarding their employment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Republic of the Philippines)

    City of __________________) S.S.


    x - - - - - - - - - - - - - - - - - - - - - - - - - - - -x

    EXIT CLEARANCE WAIVER, RELEASE AND QUITCLAIM

    I, , ___________ Filipino, of legal age, single, and a resident of _______________ ,


    Philippines, after being sworn to in accordance with law, depose and state:

    1. That by these presents, that I was hired by ___________ (hereinafter referred


    to as the “COMPANY”) as ________ last ___________;
    2. That on ___________, I have voluntarily tendered my resignation letter and
    resigned from my position effective immediately;
    3. That I hereby acknowledge to have received from the Company the sum of
    _____________________, which represents my final pay for the works I have
    rendered, and such amount also represents the full and final satisfaction of
    my salary and other benefits that may be due me for the service which I have
    rendered for the Company;
    4. That I confirm and acknowledge that I refused to undergo medical
    examinations as a requirement for my exit clearance as mandated by the
    Company due to personal reasons. With this refusal, I hereby forever
    discharge the Company, its officers, employees and staffs from any liabilities
    whatsoever in case that I shall discover later on that I have acquired any work
    related health or medical conditions during the course of my employment
    with the Company.
    5. As such, I hereby declare that I have no further claims, monetary or
    otherwise, against my employer, its President, members of the Board, officers
    or any of its staff and that I hereby release and forever discharge all of them
    from any and all claims, demands, cause of action of whatever nature arising
    out of my employment with the Company;
    6. I further agree that this WAIVER, RELEASE AND QUITCLAIM may be
    pleaded in bar to any suit or proceeding (Civil, SSS, PhilHealth, Medicare,
    Labor, etc.) to which either I, or my heirs and assigns, may have against the
    Company in connection with my employment with the latter and that the
    payment which I have received as provided herein should not in any way be
    construed as an admission of liability on the part of my employer, the
    Company, and is voluntarily accepted by me and will, if need be, serve as full
    and final settlement of any amount(s) due me or any claims or cause of action,
    either past, present, future, which I may have in connection with my
    employment with my employer;
    7. As such, I finally make manifest that I have no further claim(s) or cause of
    action against the Company nor against any person(s) connected with the
    administration and operation of the latter and forever release the latter from
    any and all liability.

    IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at


    _____________, Philippines.
    _______________________
    Affiant

    SUBSCRIBED AND SWORN to before me this _____ day of


    __________, year 2023 at ______________________, affiants exhibiting to me
    his _________________________, which is valid
    until_____________________.

    NOTARY PUBLIC

    Doc. No. _______;


    Page No. _______;
    Book No. _______;
    Series of 2023.

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