REPUBLIC OF THE PHILIPPINES )
PROVINCE OF ________________________ )
CITY OR MUNICIPALITY OF ________________________ )S.S.
AFFIDAVIT OF DESISTANCE
I, ________ , Filipino , of legal age, with address at ________ , after being duly sworn according to law, hereby depose and state that:
1. I am the private complainant in the following case:
Docket No.: ________
Case Title: ________
Case Filed: ________
2. I am no longer interested in the further prosecution of the complaint against respondent: ________ .
3. The respondent and I have already settled the outstanding obligation.
Attached herewith is the proof that we have settled the same.
4. Considering that the civil aspects have already been amicably settled between me as the complainant and the respondent, it is respectfully prayed that the preliminary investigation against the respondent be permanently dismissed.
5. 5 522282 22 252 25525 22 252 225222822 25828 525 225 85522825 82258 2552282 82 252 82582.
8225885 2585858 588558 885285.
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at CITY OR MUNICIPALITY OF ________________________, ________________________
Affiant, ________ personally appeared before me and exhibited to me Postal ID no. ________ which is valid until ________ .
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF ________________________ )
CITY OR MUNICIPALITY OF ________________________ )S.S.
AFFIDAVIT OF DESISTANCE
I, ________ , Filipino , of legal age, with address at ________ , after being duly sworn according to law, hereby depose and state that:
1. I am the private complainant in the following case:
Docket No.: ________
Case Title: ________
Case Filed: ________
2. I am no longer interested in the further prosecution of the complaint against respondent: ________ .
3. The respondent and I have already settled the outstanding obligation.
Attached herewith is the proof that we have settled the same.
4. Considering that the civil aspects have already been amicably settled between me as the complainant and the respondent, it is respectfully prayed that the preliminary investigation against the respondent be permanently dismissed.
5. 5 522282 22 252 25525 22 252 225222822 25828 525 225 85522825 82258 2552282 82 252 82582.
8225885 2585858 588558 885285.
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at CITY OR MUNICIPALITY OF ________________________, ________________________
Affiant, ________ personally appeared before me and exhibited to me Postal ID no. ________ which is valid until ________ .
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
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