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    Waiver of Rights Over Electric Power Line Sample

    Republic of the Philippines          )
    Province of __________________) SS.
    Mun/City of __________________)
    x- - - - - - - - - - - - - - - - - - - - x


    I, ___________________________, of legal age, Filipino, single/married/widow, and a resident of ______________________________________, after being sworn in accordance with law, hereby declare that I do hereby WAIVE, TRANSFER and CONVEY all my rights, interest and obligations over the electric power line with Account No. _____________ with the _____________ Electric Cooperative in favor of _________________, who is also of legal age, Filipino, single/ married/widow), and a resident of ___________________, and who is able and willing to assume all my rights and obligations in connection with the said account with _____________ Electric Cooperative.

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



    _________________________                        _________________________
    Printed Name/Signature                                   Printed Name/Signature

    SUBSCRIBED AND SWORN TO before me, in the _____________________ this day of __________________ by ________________________  who has satisfactorily proven to me his/her identity through his/her _________________________ valid until ______________________, that he/she is the same person who personally signed before me the foregoing Waiver of Rights and acknowledged that he/she executed the same.

    Doc. No. ______
    Page No. ______                                                            Notary Public
    Book No. _____
    Series of ______

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