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REPUBLIC OF THE PHILIPPINES

REGIONAL TRIAL COURT


Fourth Judicial Region
Branch 80, Morong, Rizal
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AFFIDAVIT OF DESISTANCE
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I, __________________, Filipino, of legal age, and resident of
_____________________, after having been duly sworn to in accor-
dance with law, depose and state:
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1. I am the private complainant in a criminal case for
violation of _________________ against __________________
docketed as Criminal Case No. ________________ pending before
the Regional Trial Court of __________, Branch _____;
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2. After several conferences with the accused, I hereby
declare that the same arose out of pure misunderstanding and
misapprehension of facts;
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3. Based on the said misunderstanding, misapprehension of
facts and also for the welfare of our child, I manifest that I now
withdraw my complaint against the accused and that I am no longer
interested, and I hereby desist, in prosecuting the above-mentioned
case;
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4. This Affidavit of Desistance should, however, not be
understood as a waiver or relinquishment of any of my
_____________ rights to pursue any legal action that I may file in
connection with any act or omission that the accused may commit in
the future;
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5. I hereby release the accused from any and all criminal
liabilities and waive any right of action against the accused in
connection with the above case;
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6. I fully understand the legal consequences of this Affidavit
of Desistance;
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7. I am executing this affidavit to attest to the truth of the
foregoing statements and respectfully pray that the aforementioned
case against _____________ be withdrawn and/or dismissed.
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IN WITNESS WHEREOF, we have hereunto set my hands this
_________________________ in _________________, Philippines.
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_______________________
Private Complainant
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Assisted by:
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_______________________
Private Prosecutor

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SUBSCRIBED AND SWORN TO before me this ____________
in __________________________, Philippines, affiant exhibiting to
me her ________________________ issued at _________________
issued on ___________________ as her valid proof of identification.
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Doc. No.____;
Page No. ___;
Book No. ___;
Series of 2016.

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