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Republic of the Philippines )

City of ________________ )
Province of _______ ) S. S.

AFFIDAVIT OF DESISTANCE

I, ___________________, of legal age, Filipino, (single/married), and a resident of


____________________________, after having been duly sworn to in accordance with law,
hereby depose and say:

1. That I am the private complainant in Crim. Case No.


___________________________ PEOPLE OF THE PHILIPPINES, Plaintiff, -versus-
_____________________, Accused, for (crime charged) before the (court before the case
is pending);

2. That after serious deliberation and consideration of the foregoing case, I


am finally decided to desist from further prosecution of the case for the reason
that the questioned incident was just a result of misunderstanding with the
accused, who is my son and such misunderstanding was already settled between
us;

3. That moreover, my witness who is vital in the prosecution of the case is


no longer interested to appear and testify in court;

4. That I am executing this affidavit voluntarily without force, intimidation,


threat and coercion whatsoever and the same is for the purpose of requesting this
Honorable Court for the dismissal of the aforementioned criminal case.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of


______, 20____ at ______________, Philippines.

_________________________________
Affiant/{Private Complainant

SUBSCRIBED AND SWORN to before me this ____ day of __________, 20_____,


at ________________ Philippines. I hereby certify that I have personally examined the
affiant and that I am satisfied that he voluntarily executed and understood the
same.

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