Republic of the Philippines)

Province of La Union) S.S.

San Fernando City, La Union)

COMPROMISE AGREEMENT
[With Waiver, Release and Quitclaim]

KNOW ALL MEN BY THESE PRESENTS:

This COMPROMISE AGREEMENT [With Waiver, Release and Quitclaim], executed this ___ day
of June 2018 in San Fernando City, La Union, by and among:

_________________, of legal age, Filipino, married, with residence address

at____________________, hereinafter referred to as the FIRST PARTY;

-and-

____________________, of legal age, Filipino, married, with residence address at

___________________________________, hereinafter referred to as the SECOND PARTIES;

WITNESSETH: THAT

WHEREAS, the FIRST PARTY and the SECOND PARTY has been involved in a vehicular
accident inthe morning of May 23, 2012 at Pasig City being the drivers of a Suzuki Jimny with
plate no. ________ and an unregistered motorcycle, respectively;

WHEREAS the vehicle of the FIRST PARTY has incurred unestimated damages on the front
portion thereof;

WHEREAS the motorcycle of the SECOND PARTY likewise incurred damages;

WHEREAS the SECOND PARTY sustained physical injuries because of the said accident and is
now being treated at ______________Hospital;

WHEREAS the SECOND PARTY has already extended financial help in favor of the SECOND
PARTY during the first day of the latter’s hospitalization in the sum of more or
____________________________( ________________) Philippine Currency;

WHEREAS, both parties are desirous of settling amicably the incident and thereby avoiding along
and costly litigation;

NOW, THEREFORE, in consideration of the foregoing premises, the parties hereby undertake
asfollows:

1. The FIRST PARTY shall voluntarily undertake to give the additional sum of
________________________________ (P _____________) Philippine Currency in favor of the
SECOND PARTY to answer for the latter’s medical needs and whatever damages he may have
sustained due to the said accident:

2. The parties agree to, release each other free from any liabilities and obligation/s
whatsoeverresulting from the accident, including all claims and counterclaims therein, and agree
not to fileany case, whether civil, administrative or criminal, of any kind or nature whatsoever, in
anycourt, tribunal, or government agencies execerciseing qusi-judicial function arising from
thesame facts, incident, claim, cause or causes of action