REPUBLIC OF THE PHILIPPINES )

PROVINCE/CITY OF ______________ ) SS.

AFFIDAVIT OF DESISTANCE

That We, THE IMMEDIATE FAMILY AND RELATIVES OF JOSHUA DIACOR VELAROSO,
Filipino, of legal ages, married and a resident of ____________________, after having been duly sworn to in
accordance with law, hereby voluntarily depose and say:

1. That We are the immediate family members and relatives of Joshua Diacor Velaroso, the driver of one
motorcycle unit one particularly identified as a Yamaha Mio I 125 BB35 MC 2017 having Plate No.
070104 that figured in an accident sometime on September 13, 2018;

2. That as a result of the said accident, our son and family member, Joshua Diacor Velaroso, unfortunately
died when transported to the hospital;

3. That we fully understand and accept that said unfortunate event is purely accidental in nature and was not
attended by negligence on the part of the driver or owner;

4. That the owner of the motor vehicle, PROVIDENCE INTEGRAL FREIGHT SOLUTIONS INC., and its
owners, had likewise extended to our full satisfaction all the assistance that they could provide to cover
for the expenses incurred owing;

5. That in view of the foregoing, WE do hereby freely, voluntarily, and absolutely release, clear, absolve,
and discharge the said PROVDIENCE INTEGRAL FREIGHT SOLUTIONS INC, and its owners,
and their driver ROBERT TAWAT from any action, cause of action, sum of money, liability, damages,
claims and demands whatsoever, which in law or in equity we have, or which our heirs, insurer, successors
and assigns hereafter may have upon or by reason of the injuries sustained by me arising from the said
incident;

6. That we further warrant that we will institute no further action, civil, criminal or otherwise, against the
PROVDIENCE INTEGRAL FREIGHT SOLUTIONS INC, and its owners, and their driver
ROBERT TAWAT arising from, by reason of, or in connection with, the aforementioned vehicular
accident.

7. That I have fully read or caused to be interpreted, and understood the contents of this affidavit, that the
same reflects my true intention, and that I am also fully aware of the legal effects of executing and signing
of the same.

IN WITNESS WHEREOF, I have hereunto set my hand this __________________, in

_______________________________.

_________________________ _________________________
Name over Printed Signature Name over Printed Signature
AFFIANT AFFIANT

_________________________ _________________________
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AFFIANT AFFIANT

_________________________ _________________________
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AFFIANT AFFIANT

_________________________ _________________________
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AFFIANT AFFIANT
SIGNED IN THE PRESENCE OF:

_________________________ _________________________
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WITNESS WITNESS

SUBSCRIBED AND SWORN TO before me this _________ day of _________________ affiant

exhibiting to me their ____________________________.

Doc. No.
Page No.
Book No.
Series of 2018.