Anda di halaman 1dari 2

REPUBLIC OF THE PHILIPPINES)

BACOLOD, LANAO DEL NORTE) S.S.

AFFIDAVIT OF DESISTANCE

I, Leah Mae Bongcawil, of legal age, married, and a resident of Maigo Lanao del
Norte, after having duly sworn to in accordance with law hereby depose and state:

1. I am the complaining witness for Reckless Imprudence resulting to


Homicide against Jesus Santos in the case entitled "People of the Philippines versus
Jesus Santos", Criminal Case No. 12345, Metropolitan Trial Court, Branch No. 11,
City of Manila.

2. After my sober and soul searching assessment and analysis of the incident, I
have realized that because I was not wearing my eyeglasses and it was dark, I can not
point out, without a doubt the accused or any other person/s who inflicted harm
against me.

3. Since I could not state with certainty and without doubt the liability of Jesus
Santos, in fairness to him, I am permanently withdrawing my complaint against him. I
clear him of whatever responsibility or liability to me.

4. I hereby inform the City Prosecutor of Manila that I am withdrawing my


complaint for Serious Physical Injuries in Criminal Case No. 12345 entitled "People
of the Philippines versus Jesus Santos", Metropolitan Trial Court, Branch No. 11, City
of Manila.

5. I likewise request the Metropolitan Trial Court, Branch No. 11, City of Manila
to dismisswith prejudice the said criminal case.

IN WITNESS WHEREOF, I hereby set my hand this __ day of September 20__


at the City of Manila.

Juan de la Cruz
Complaining Witness
SUBSCRIBED AND SWORN to before me this 22nd day of January 20__ at the City
of Manila, Philippines.

Romeo Abad
Public Prosecutor