Anda di halaman 1dari 1


I, XXX, of legal age, Filipino, and residing in Diliman, Quezon City, after having
duly sworn to in accordance with law hereby deposes and states THAT:

1. I am the private complainant in the case PEOPLE OF THE PHILIPPINES

versus YYY docketed as CRIMINAL CASE No. 12345 pending before the Regional Trial
Court, Branch 225, Quezon City;

2. I and the accused YYY had entered into a Compromise Agreement 1 to settle
the civil aspect of the said case;

3. In view of the execution of the Compromise Agreement, I have finally

decided to desist from further pursuing the above-mentioned case against accused YYY;

4. I am aware that if the said case would be dismissed by the Honorable Court,
it could no longer be revived or refiled;

5. I therefore respectfully request that the above-mentioned case filed against

YYY be dismissed as in fact I now withdraw my complaint against him and I further
manifest under oath that I am now desisting from testifying against him in Court or in
any other government entity or agency in connection with the said criminal case;

6. I execute this affidavit of my own free will and that no one forced nor
intimidated me; and

7. I attest to the truthfulness and veracity of the foregoing.

IN WITNESS WHEREOF, I hereby set my hand this ___________ at



SUBSCRIBED AND SWORN to before me this _______________ at

_________________ with his Competent Identity __________________________________.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017.

A copy of the Compromise Agreement is hereto attached as ANNEX A