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    Waiver of Rights To Claim

    Uploaded by

    Atty. Ed Mark Baroy
    This document is a waiver of rights to claim insurance benefits signed by three individuals. [1] They state that they are the legitimate heirs/beneficiaries of the deceased insured. [2] They voluntarily waive all rights and interests to claim the insurance benefits on the life of the deceased insured, instead granting those benefits to another individual. [3] The three individuals signed the waiver freely and it was notarized, acknowledging their identities and that the waiver represents their free and voluntary act.

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    © All Rights Reserved
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    Waiver of Rights To Claim

    Uploaded by

    Atty. Ed Mark Baroy
    354 views1 page
    This document is a waiver of rights to claim insurance benefits signed by three individuals. [1] They state that they are the legitimate heirs/beneficiaries of the deceased insured. [2] They voluntarily waive all rights and interests to claim the insurance benefits on the life of the deceased insured, instead granting those benefits to another individual. [3] The three individuals signed the waiver freely and it was notarized, acknowledging their identities and that the waiver represents their free and voluntary act.

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    Waiver of Rights to Claim

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    This document is a waiver of rights to claim insurance benefits signed by three individuals. [1] They state that they are the legitimate heirs/beneficiaries of the deceased insured. [2] They voluntarily waive all rights and interests to claim the insurance benefits on the life of the deceased insured, instead granting those benefits to another individual. [3] The three individuals signed the waiver freely and it was notarized, acknowledging their identities and that the waiver represents their free and voluntary act.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    354 views1 page

    Waiver of Rights To Claim

    Uploaded by

    Atty. Ed Mark Baroy
    This document is a waiver of rights to claim insurance benefits signed by three individuals. [1] They state that they are the legitimate heirs/beneficiaries of the deceased insured. [2] They voluntarily waive all rights and interests to claim the insurance benefits on the life of the deceased insured, instead granting those benefits to another individual. [3] The three individuals signed the waiver freely and it was notarized, acknowledging their identities and that the waiver represents their free and voluntary act.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    REPUBLIC OF THE PHILIPPINES )

    PROVINCE OF _______________ ) s.s

    WAIVER OF RIGHTS TO CLAIM

    We, __________________________, of legal age, Filipino and a resident of


    _________________, ________________________, ________________________, of legal age,
    Filipino and a resident of _______________________, and _____________________, of legal
    age, Filipino, and a resident of ________________________, after having been duly sworn to in
    accordance with law, depose and state:

    That we are the surviving legitimate heirs/beneficiaries of the deceased-insured


    ________________________;

    That for reasons of gratuity and generosity, we hereby waive all our rights and interest to
    claim the insurance benefits on the life of the aforementioned deceased-insured, in favor of
    ________________________;

    That we execute this waiver, freely and voluntarily to attest to the foregoing facts and
    statements and for whatever legal purpose it may serve.

    IN WITNESS WHEREOF, we have herewith affixed our signatures this


    _____________________________ at _________________________________.

    _________________ _____________________
    Affiant Affiant
    Id:______________________ Id:________________________

    ___________________________
    Affiant
    Id: ___________________________

    ACKNOWLEDGMENT

    BEFORE ME, this _________________________, a Notary Public in the Province of


    ___________________, Philippines, personally appeared the following persons with their valid
    identification card, known to me to be the same persons who executed the foregoing instrument
    and acknowledged to me that the same is their free and voluntary act and deed.

    Witness My Hand and Notarial Seal on.

    NOTARY PUBLIC

    Doc. No. ______;


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

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