Republic of the Philippines)

Province of_______________)S.S.
City/Municipality of____________)
x---------x

AFFIDAVIT OF DESISTANCE

I,____________,Filipino, single, with residence__________, under oath

allege:

1.That I am the complainant in Criminal Case No.__________for alleged

"RAPE" against accused___________, which case is pending before the
Regional Trial Court, Branch______, _____________City, Philippines;

2.That I signed the aforesaid complaint against accused__________against

my will, my signature in the complaint having been obtained thru force,
violence and intimidation done to me by my parents;

3.There is no truth to the allegations contained in my sworn statement

executed by me against my will on___________at____________, taken
by____________. There was no force, violence or intimidation done against
me by said accused___________. I was not forced by him to submit to his
desires. It was all in accordance with my own will, volition and consent that I
went personally to him because we love each other and I agree and consent
to live with him as my husband;

4.I therefore respectfully request that the above-mentioned case filed

against said___________be dismissed as in fact I now withdraw my
complaint against him and I further manifest under oath that I am now
desisting from testifying against him in Court or in any other government
entity or agency in connection with the said criminal case.

IN WITNESS WHEREOF, I have hereunto set my hand

this___________at____________, Philippines.

AFFIANT
(JURAT)