Republic of the Philippines

Province of Negros Oriental) S. S

Dumaguete City

AFFIDAVIT

I, JELBERT L. ACABAL, of legal age, married, Filipino, and a resident of

Juan Kuna Street, Bais City, Negros Oriental, Philippines, after having been
duly sworn to in accordance with law do hereby depose and state:

1. That I was involved in a vehicular accident last July 27, 2019 around
11:00 o’clock in the morning at Ajong, Sibulan, Negros Oriental;

2. That I was traveling to the North direction when GLAIZA TURTAL

PEŇAFLOREDA, who was heading toward the South direction and
who was driving a Toyota Wigo, swerved to the left and so I bumped
into the car;

3. That in view of the nature of the accident, I am hereto desisting from

filing any criminal and civil complaint against GLAIZA TURTAL
PEŇAFLOREDA;

4. That I have received financial assistance from GLAIZA TURTAL

PEŇAFLOREDA by way of cash in the total amount of Fifty Thousand
Pesos (PhP 50, 000.00)and by way of four(4) post-dated checks with
a total value of Fifty Thousand Pesos (PhP 50, 000.00);

5. That I am executing this affidavit voluntarily to attest to the truth or

veracity of the foregoing statements and henceforth desists in filing
a criminal and civil complaint against GLAIZA TURTAL PEŇAFLOREDA,
as well as testifying against her; however, this desistance is without
prejudice to filing of any civil or criminal case if any of the posted-
dated checks issued will be dishonored and/or uncertified for
payment by the depository bank; -and that

further, GLAIZA TURTAL PEŇAFLOREDA agreed to provide and process

the necessary requirements to claim the THIRD PARTY LIABILITY (TPL) insurance
intended to me as the aggrieved party who suffered serious physical injuries.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________, at

Dumaguete City, Negros Oriental, Philippines.

JELBERT L. ACABAL
Affiant

SUBSCRIBED AND SWORN to before me this _________________________,

at Dumaguete City, Negros Oriental, Philippines, affiant exhibiting to me his
Driver’s License No. _________________ as his identification. I hereby certify that
I have personally examined the affiant and that I am convinced that he
understood the contents of his affidavit and that the same is his free and
voluntary act.

Doc No.________
Page No._______
Book No._______
Series of 2019.