(Affidavit of Desistance – Rape Case)

REPUBLIC OF THE PHILIPPINES )

Province of____________________ ) S.S.
City/Municipality of_____________ )
x-------------------------------------------x

AFFIDAVIT OF DESISTANCE

I, ____________________________________, Filipino,
single(civil status), ___ years old, with residence at
______________________________________________, 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 against my will, the aforesaid complaint against

_____(name of accused)_______________ .

3. My signature in the complaint having been obtained through

force, violence and intimidation done to me by my parents;

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

statement executed by me against ______________________ on
______________________ at _______________, taken by
_______________.

5. There was no force, violence or intimidation done against me

by the 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 future husband;

6. 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 any
other government entity or agency in connection with the said
criminal case.

IN WITNESS WHEREOF, I have hereunto set my hands this

_____________, at ______________, Philippines.
 ______________________________

AFFIANT

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

_________(City/Province)____________ this ____th day of ____________
20___. Affiant personally came and appeared with _____________(Competent
Evidence of Identity)______ issued by the _________(Government
Agency)______ on ___(date)__ at ________(place)_________, bearing his
photograph and signature, known to me as the same person who personally
signed the foregoing instrument before me and avowed under penalty of law to
the whole truth of the contents of said instrument.

Atty _______________________________________
Notary Public
Doc. No. ____ Commission Serial No. __________________
Page No. ____ Notary Public for _______(Province/City)_____
Book No. ____ Until December 31, 20__
Series of 20__ Office: ____________(address)____________
Roll No. __________
IBP Lifetime Roll No. ________; __/__/__ ; (Province)
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__

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