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Data Privacy Waiver

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REPUBLIC OF THE PHILIPPINES)

_____________________________ ) S.S.

DATA PRIVACY WAIVER

I, (Name of Affiant)., Filipino, of legal age, residing at (Address of Affiant), after


having been sworn in accordance with law hereby depose and state:

1. That I have submitted the following documents to the Angel’s


Burger Franchising office:

a. Bank Certificate dated XXX,


b. Bank Statement dated XXX,
c. Letter of Intent dated XXX &
d. Character reference authored by XXX;

2. That I hereby waive my right to privacy granted by the Data Privacy


Act (Republic Act. 10173), The Philippine Constitution and other
similar and related statues in relation to the documents described
above;

3. That I am executing this affidavit to grant Angel’s Burger, its


owners, employees and other enterprise related natural or juridical
persons authority to use, disseminate and process the documents
described above for any lawful business purpose.

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


_______________. 20___ at _________________________.

(Name Over Signature of Affiant)

SUBSCRIBED AND SWORN to before me, this ____ day of ______________,


20___ in ___________________ City, with affiant exhibiting his CTC No.
_______________ ,
Issued on ______________________ at _________________________.

NOTARY PUBLIC
Until December 31, 200___

Doc. No. : ________;


Page No. : ________;
Book No. : ________;
Series of 20_______.

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