Republic of the Philippines)

Rodriguez, Rizal) S.S

AFFIDAVIT OF DESISTANCE

I, ______________________________, of legal age and

_____________________________________, after having duly
accordance with law, hereby depose and state that:

a resident of
sworn to in

1. I have recently brought a case for Slight Physical Injuries against

________________________________
in
the
case
entitled
______________________________________,
Criminal
Case
No.
______________, Municipal Trial Court of Rodriguez, Rizal;
2. After both accused and I had a recent conversation regarding the
above case during the mediation set before the Philippine Mediation
Center of Rodriguez, Rizal, both of us decided to settle the problem
amicably by entering into a Compromise Agreement, a copy of which
is herein attached as ANNEX A hereof;
3. Due to the aforesaid developments between both accused and I, I am
permanently withdrawing the complaint that I have filed against him/
her. I clear him/ her of whatever responsibility or liability she/he has
towards me;
4. I hereby inform the Public Prosecutor of Rodriguez, Rizal that I am
withdrawing the complaint for Slight Physical Injuries against
___________________________
in
the
case
entitled
___________________________________,
Criminal
Case
No.
_______________________, Municipal Trial Court of Rodriguez;
5. I likewise request the Municipal Trial Court, Branch ____ of Rodriguez,
to dismiss with prejudice the said criminal case, both on its criminal
and civil aspect.

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

June 2016 at Rodriguez, Rizal, Philippines.
_______________________________
Affiant

SUBSCRIBED AND SWORN to before me this ______ day of June 2016 at

Rodriguez, Rizal, Philippines.

PUBLIC PROSECUTOR