REPUBLIC OF THE PHILIPPINES )

Province of ____________________) S.S.

City/Municipality of _____________ )
x---------------------------------------x
AFFIDAVIT OF DESISTANCE
I, ________________(Complaining Witness)____________, Filipino, of legal age, [single]/
[married
to
_________(name
of
spouse)_________],
and
a
resident
of
___________________(address of affiant)_______________, after having been duly sworn in
accordance with law, hereby depose and state:
1. That I am the complainant in Criminal Case No. ______________, entitled "People of
the Philippines versus ______________", for alleged RAPE against accused
_______________________, which case is pending before the Regional Trial Court,
Branch No. _______, _______________ City, Philippines;
2. That I signed the aforesaid complaint against accused _____________________
against my will;
3. That my grandparents will cut-off my monthly allowances if I do not sign the complaint;
4. There is no truth to the allegations contained in my sworn statement executed by me
that states:
______________________________________;
_______________________________________;
5. I hereby inform the Public Prosecutor of _______________ that I am withdrawing my
complaint for __________ in Criminal Case No. _________ entitled "People of the
Philippines versus ______________", Regional Trial Court, Branch No.__,
_________City, Philippines.
6. I likewise request the Regional Trial Court, Branch No.__, _____________City,
Philippines, to dismiss with prejudice the said criminal case.
IN WITNESS WHEREOF, I have hereunto set my hands this
______________, Philippines.

_________________
Complaining Witness

(JURAT)
_______________
Public Prosecutor

_____________, at